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NPI Code Detail

MEDICARE: LAUREN ACCOR

MEDICARE: LAUREN ACCOR
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program
2363A00000XPhysician Assistant12728GA

General Provider Information

NPI Number : 1578251633
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAUREN ACCOR
Provider Business Mailing Address
First Line : 1220 MECASLIN ST NW APT 2330
Second Line :
City : ATLANTA
State : GA
Zip : 30318-5656
Country : US
Telephone Number : 704-648-1872
Fax Number :
Provider Business Practice Location Address
First Line : 882 PONCE DE LEON AVE NE # 2330
Second Line :
City : ATLANTA
State : GA
Zip : 30306-4268
Country : US
Telephone Number : 770-809-3034
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/26/2023
Last Update Date : 05/08/2026

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Directions to “ LAUREN ACCOR ” Practice Location

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