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NPI Code Detail

MEDICARE: DR. LORI SPITZER CORLEY MD

MEDICARE: DR. LORI SPITZER CORLEY MD
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
1208000000XPediatrics Physician034251GA

General Provider Information

NPI Number : 1063401289
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LORI SPITZER CORLEY MD
Provider Business Mailing Address
First Line : 3707 LARGENT WAY NW
Second Line :
City : MARIETTA
State : GA
Zip : 30064-1672
Country : US
Telephone Number : 678-581-5729
Fax Number : 678-581-5719
Provider Business Practice Location Address
First Line : 3707 LARGENT WAY NW
Second Line :
City : MARIETTA
State : GA
Zip : 30064-1672
Country : US
Telephone Number : 678-581-5729
Fax Number : 678-581-5719
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/20/2005
Last Update Date : 07/08/2007

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Directions to “ DR. LORI SPITZER CORLEY MD” Practice Location

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