West Georgia Medical Center INC

NPI #1558592089 in Lagrange, Georgia

Provider Information

NPI Number: 1558592089
Entity Type: Organization
Organization Name: West Georgia Medical Center INC
Subpart: Yes (part of a larger organization)
Parent Organization: WEST GEORGIA MEDICAL CENTER, INC
Primary Specialty: Internal Medicine - Interventional Cardiology
Enumeration Date: Jul 31, 2009
Last Updated: Oct 13, 2009

Practice Location

Address: 1551 DOCTORS DR
Address 2: BLDG 200
City: Lagrange
State: Georgia
ZIP Code: 30240-4139
Phone: (706) 884-2641

Authorized Official

Name: GERALD FULKS
Title: PRES / CEO
Phone: (706) 882-1411

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine - Cardiovascular Disease — Cardiovascular Disease	207RC0000X
Internal Medicine - Interventional Cardiology — Interventional Cardiology	207RI0011X	Primary

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