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Tracy Lane D.O. NPI 1013923218

Classification
Independent Medical Examiner
Type
License No.
55676
License State
GA
Certified
Location

Additional Identifiers

Medical School
Yes
Graduation Year
0
Identifier
Type
State
Identifier: 535673028C
Type: MEDICAID (05)
State: GA
Identifier: 535673028B
Type: MEDICAID (05)
State: GA
Identifier: H60120
Type: MEDICARE UPIN (02)
State: GA
Identifier: 202I088894
Type: MEDICARE PIN (08)
State: GA

Hospital & Clinics

Business Name
Company Size
Revenue
Business Address
2221 PEACHTREE RD NE, ATLANTA, GA, 30309
Business Phone
404-855-4503
Mailing Address
2221 PEACHTREE RD NE, ATLANTA, GA, 303091148
Mailing Phone
404-855-4503
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