| Lagrange Primary Care PC | |
|
505 Jenkins St Lagrange GA 30240-4225 | |
| (678) 923-9486 | |
| (678) 401-0292 |
| Full Name | Lagrange Primary Care PC |
|---|---|
| Speciality | Internal Medicine |
| Location | 505 Jenkins St, Lagrange, Georgia |
| Authorized Official Name and Position | Vishwas Kadam (OWNER) |
| Authorized Official Contact | 6789239486 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lagrange Primary Care PC 25 Turnberry Cir Newnan GA 30265-4154 Ph: (678) 923-9486 | Lagrange Primary Care PC 505 Jenkins St Lagrange GA 30240-4225 Ph: (678) 923-9486 |
| NPI Number | 1548501380 |
|---|---|
| Provider Enumeration Date | 03/04/2013 |
| Last Update Date | 06/25/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548501380 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 062529 (Georgia) | Primary |
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