DERRICK LANE, MD, LLC

MACON, GA
NPI1750620191
Entity TypeOrganization
Authorized ContactDERRICK LANE
Owner
478-335-1365
Organization Subpart ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: GA  052594)
Enumeration Date2013-02-05
Last Update Date2013-02-05
Business Address
DERRICK LANE, MD, LLC
818 FORSYTH ST
MACON, GA 31201-2139
Phone number: 478-633-7010
Mailing Address
DERRICK LANE, MD, LLC
PO BOX 28170
MACON, GA 31221-8170
Phone number:
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