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Lafayette After Hours, LLC

Family Medicine in La Fayette, GA. Organization (NPI-2).

NPI number1124074992
StatusActive
Last updated in NPPESAug 22, 2020

Details

NPI
1124074992
Entity type
Organization (NPI-2)
Legal business name
Lafayette After Hours, LLC
Organization subpart
No
Enumeration date
May 25, 2006
Last updated
Aug 22, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine––Yes

Practice location

615 E Villanow St
La Fayette, GA 30728-2618

Phone 423-495-4839 · Fax 423-495-7887

Mailing address

615 E Villanow St
La Fayette, GA 30728-2618

Phone 423-495-4839 · Fax 423-495-7887

Authorized official

Aloysius T Mangan
Medical Director
7066386016

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