Organization
LVD SURGICAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LATARA V DEMPS MD (MD)
(404) 815-7951
Entity
Organization
Contact information
Practice address
1 BALTIMORE PL NW, ATLANTA, GA 30308-2116
(404) 815-7951
(404) 815-7953
Mailing address
939 QUEENSBROOKE WAY, MABLETON, GA 30126-6413
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
053131
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1457361206
INDIVIDUAL NPI
GA
Enumeration date
11/05/2012
Last updated
11/05/2012
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