Cantrell Lake Inpatient Services LLC

NPI #1497281133 in Bremen, Georgia

Provider Information

NPI Number: 1497281133
Entity Type: Organization
Organization Name: Cantrell Lake Inpatient Services LLC
Primary Specialty: Hospitalist
Enumeration Date: May 1, 2017
Last Updated: Mar 27, 2023

Practice Location

Address: 200 ALLEN MEMORIAL DR
City: Bremen
State: Georgia
ZIP Code: 30110-2012
Phone: (973) 251-1132

Authorized Official

Name: KAREN VAUGHN
Title: OFFICER
Phone: (404) 450-4684

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X
Nurse Practitioner	363L00000X
Hospitalist	208M00000X	Primary

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