Lafayette After Hours, LLC

Organization Active NPI Family Medicine Physician · La Fayette, GA

NPI 1124074992 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1124074992
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
LAFAYETTE AFTER HOURS, LLC
Practice address
615 E Villanow St
La Fayette, GA 30728-2618
Phone
(423) 495-4839
Fax
(423) 495-7887
NPI assigned
May 25, 2006
Organization subpart
No

Authorized official

Name
Dr. Aloysius T Mangan
Title
Medical Director
Phone
(706) 638-6016

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207Q00000X Yes

Addresses

Primary practice location

615 E Villanow St
La Fayette, GA 30728-2618

Mailing address

615 E Villanow St
La Fayette, GA 30728-2618
Phone (423) 495-4839

Other providers in La Fayette, GA

All providers in La Fayette, GA · Family Medicine Physician in Georgia

Sources for this page

Verify at the official NPI Registry.