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General NPI Number Information
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NPI Number | 1225647274
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Entity Type | Organization
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Legal Business Name | L&D MEDICAL CENTER, LLC
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Dates
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Enumeration Date | 07/27/2020
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Last Update Date | 07/27/2020
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Provider Practice Location Address
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Address Line | 5041 DALLAS HWY STE G
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City | POWDER SPRINGS
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State | GA
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Zip | 30127-6458
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Country | US
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Telephone | 855-722-3563
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Fax |
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Provider Business Mailing Address
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Address Line | 5041 DALLAS HWY STE G
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City | POWDER SPRINGS
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State | GA
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Zip | 30127-6458
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Country | US
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Telephone | 855-722-3563
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DOUGLAS COX
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Credential | NP-C
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Telephone | 678-612-9101
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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