Healthcare Provider Details

I. General information

NPI: 1104828573
Provider Name (Legal Business Name): LAMAR COUNTY HEALTH DEPARTMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2005
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 ACADEMY DR
BARNESVILLE GA
30204-3526
US

IV. Provider business mailing address

100 ACADEMY DR
BARNESVILLE GA
30204-3526
US

V. Phone/Fax

Practice location:
  • Phone: 770-358-1483
  • Fax: 770-358-1258
Mailing address:
  • Phone: 770-358-1483
  • Fax: 770-358-1258

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License NumberD28997
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code261QP0905X
TaxonomyState or Local Public Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KYLIE MYHAND
Title or Position: BILLING SUPERVISOR
Credential:
Phone: 706-298-7709