Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 076360 | GA |
NPI | 1053637280 |
---|---|
Provider Name | Joseph Daniel Lutgring |
First Address | Atlanta, GA 30322-1064 |
Second Address | Atlanta, GA 30322-1064 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2010 |
Last Update Date | 30/06/2016 |