Connecticut General Life Insurance Company

NPI #1851716195 in Lagrange, Georgia

Provider Information

NPI Number: 1851716195
Entity Type: Organization
Organization Name: Connecticut General Life Insurance Company
Primary Specialty: Clinic/Center
Enumeration Date: Feb 24, 2014
Last Updated: Feb 24, 2014

Practice Location

Address: 1503 ORCHARD HILL RD
City: Lagrange
State: Georgia
ZIP Code: 30240-5709
Phone: (706) 812-6131

Authorized Official

Name: STACEY POPKO
Title: MEDICAL SENIOR DIRECTOR
Phone: (412) 747-4128

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center	261Q00000X	Primary

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