Cantrell Lake Inpatient Services LLC

Organization Active NPI Hospitalist Physician · Bremen, GA

NPI 1497281133 · NPPES record last updated Mar 27, 2023

Key facts

NPI
1497281133
Entity type
Organization (NPI type 2)
Primary specialty
Hospitalist Physician 208M00000X
Legal business name
CANTRELL LAKE INPATIENT SERVICES LLC
Practice address
200 Allen Memorial Dr
Bremen, GA 30110-2012
Phone
(973) 251-1132
NPI assigned
May 1, 2017
Organization subpart
No

Authorized official

Name
Karen Vaughn
Title
Officer
Phone
(404) 450-4684

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician
Group: 193200000X MULTI-SPECIALTY GROUP
208M00000X Yes
Physician Assistant
Group: 193200000X MULTI-SPECIALTY GROUP
363A00000X
Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP
363L00000X

Addresses

Primary practice location

200 Allen Memorial Dr
Bremen, GA 30110-2012

Mailing address

13737 Noel Rd
1600
Dallas, TX 75240-1331
Phone (973) 251-1132

Other providers in Bremen, GA

All providers in Bremen, GA · Hospitalist Physician in Georgia

Sources for this page

Verify at the official NPI Registry.