Organization
LAWRENCE KIRK MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAWRENCE F KIRK JR. (MD)
(478) 956-2648
Entity
Organization
Contact information
Practice address
200 GA HIGHWAY 49 S, BYRON, GA 31008-6937
(478) 956-2648
Mailing address
PO BOX 26040, MACON, GA 31221-6040
(478) 475-1299
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
042072
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DE5634
RAILROAD MEDICARE
GA
Enumeration date
11/10/2006
Last updated
12/17/2009
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