Lagrange Primary Care PC

NPI #1548501380 in Lagrange, Georgia

Provider Information

NPI Number: 1548501380
Entity Type: Organization
Organization Name: Lagrange Primary Care PC
Primary Specialty: Internal Medicine
Enumeration Date: Mar 4, 2013
Last Updated: Jun 25, 2013

Practice Location

Address: 505 JENKINS ST
City: Lagrange
State: Georgia
ZIP Code: 30240-4225
Phone: (678) 923-9486

Authorized Official

Name: DR. VISHWAS KADAM, M.D.
Title: OWNER
Phone: (678) 923-9486

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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