Individual
DR. LARRY WELLS GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
350 HOSPITAL DR, MACON, GA 31217-3838
(478) 464-1326
(478) 464-1323
Mailing address
4635 BRAE BURN LN, MACON, GA 31210-4710
(478) 474-8129
(478) 464-1323
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
016802
GA
Other
Enumeration date
02/26/2007
Last updated
07/08/2007
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