Brack, Lawrence F

Brack, Lawrence F is an sole proprietor health care provider with primary practice located at 5900 Hillandale Dr Suite 345, Lithonia GA 30058-3802. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Brack, Lawrence F can be contacted via phone (770) 987-0733.

Contact Information

Primary practice address
5900 Hillandale Dr Suite 345 Lithonia GA 30058-3802
Fax: (770) 987-3978
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 047403 Georgia

Profile Details

NPI number 1265441315
LBN Legal business name Brack, Lawrence F
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 7th, 2006
Last updated Jun 13th, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265441315 NPPES
Georgia MEDICAID 000898422C

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