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West Georgia Dermatology Pc
Specialist in Lagrange, Georgia
NPI 1760493167

West Georgia Dermatology Pc is a Specialist based in Lagrange, GA. West Georgia Dermatology Pc practices in Lagrange, GA. The NPI Number for West Georgia Dermatology Pc is 1760493167 and holds a License No. 30949 (Georgia).

The current practice location address for West Georgia Dermatology Pc is 1605 Whitesville St, Lagrange, GA and can be reached out via phone at 706-882-5119 and via fax at 706-882-0270.

Location: 1605 Whitesville St, Lagrange, GA, 30240-5903
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1760493167
Provider Name
West Georgia Dermatology Pc
Credential
Provider Entity Type
Organization
Address
1605 Whitesville St, Lagrange, GA, 30240-5903
Phone Number
706-882-5119
Fax Number
706-882-0270
Provider Enumeration Date
08/10/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
280767 01 GA BC/BS PROVIDER NUMBER
institution
Provider Business Practice Location Address Details
Address
1605 Whitesville St
City
Lagrange
State
Georgia
Zip
30240-5903
Phone Number
706-882-5119
Fax Number
706-882-0270
person
Provider Business Mailing Address Details
Address
1605 Whitesville St
City
Lagrange
State
Georgia
Zip
30240-5903
Phone Number
706-882-5119
Fax Number
706-882-0270
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
30949 (Georgia)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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