| Payton Hunter Lack, AUD | |
|
1051 Parkside Cmns Ste 103, Greensboro, GA 30642-4517 | |
| (706) 623-4425 | |
| Not Available |
| Full Name | Payton Hunter Lack |
|---|---|
| Gender | Male |
| Speciality | Audiologist |
| Location | 1051 Parkside Cmns Ste 103, Greensboro, Georgia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043901390 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 231H00000X | Audiologist | AUD004368 (Georgia) | Primary |
| Provider Name | North Georgia Audiology And Hearing Aid Center, Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1063845246 PECOS PAC ID: 2062654437 Enrollment ID: O20130814000575 |
| Mailing Address | Practice Location Address |
|---|---|
| Payton Hunter Lack, AUD 1051 Parkside Cmns Ste 103, Greensboro, GA 30642-4517 Ph: (706) 623-4425 | Payton Hunter Lack, AUD 1051 Parkside Cmns Ste 103, Greensboro, GA 30642-4517 Ph: (706) 623-4425 |
Oconee Hearing Center, Llc Audiologist Medicare: Not Enrolled in Medicare Practice Location: 1041 Founders Row, Suite B, Greensboro, GA 30642 Phone: 706-453-1688 Fax: 706-453-2884 | |
Atlanta Hearing Associates Of Lake Oconee, Llc Audiologist Medicare: Not Enrolled in Medicare Practice Location: 1051 Parkside Cmns, Suite 103, Greensboro, GA 30642 Phone: 706-454-0578 Fax: 706-454-0575 |