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Individual

LAWRENCE A. BIRCOLL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
487 WINN WAY, SUITE 100, DECATUR, GA 30030-1735
(770) 491-3003
(770) 491-0729
Mailing address
487 WINN WAY, SUITE 100, DECATUR, GA 30030-1735
(770) 491-3003
(770) 491-0729

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
036926
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000553902E
GA
05
000553902F
GA
05
000553902G
GA
Enumeration date
10/04/2005
Last updated
08/13/2014
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