John William Carl Carter Mallett, MD
Anesthesiology in Lagrange, GA. Individual provider (NPI-1).
NPI number1003310863
StatusActive
Last updated in NPPESAug 7, 2025
Details
- NPI
- 1003310863
- Entity type
- Individual (NPI-1)
- Name
- John William Carl Carter Mallett
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 19, 2018
- Certification date
- Aug 7, 2025
- Last updated
- Aug 7, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207L00000X | Anesthesiology | 95070 | GA | Yes |
| 207LP2900X | Anesthesiology, Pain Medicine | 95070 | GA |
Practice location
1075 Lafayette Pkwy Ste 100Lagrange, GA 30241-3507
Phone 706-443-5273 · Fax 706-443-5275
Mailing address
1075 Lafayette Pkwy Ste 100Lagrange, GA 30241-3507
Phone 706-443-5273 · Fax 706-443-5275
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