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Individual

LATOYA JEAN LEE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1325 RALPH DAVID ABERNATHY BLVD SW, ATLANTA, GA 30310-1649
(404) 836-0136
(404) 753-5266
Mailing address
3371 BUFORD HWY NE, BROOKHAVEN, GA 30329-1709
(404) 836-0230
(305) 698-6536

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
76289
GA
207Q00000X
Family Medicine Physician
LL35942
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
76289
GA PROVIDER LICENSE- MD
GA
Enumeration date
06/19/2013
Last updated
10/07/2019
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