JEANPHIS LAGUERRE MD PC
Medical Practice at 2 St, Moultrie, GA

License number
Georgia 059815
Category
Medical Practice
Type
Specialist
Owner
Name: JUDY B RICKS
Title: PROVIDER ENROLLMENT COORDINATOR
Phone: (229) 891-9131
Address
Address
3007B 2Nd St SE, Moultrie, GA 31768
National Provider ID: 1336397595
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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JEANPHIS LAGUERRE, M.D., PC

PO Box 1838, Moultrie, GA 31776

Status:
Inactive
Registration:
Jul 18, 2007
Inactive since:
Jan 14, 2015
State ID:
07059195
Business type:
Domestic Professional Corporation
CEO:
Jeanphis Laguerre (CEO), PO Box 1838, Moultrie, GA 31776 (Physical)

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