James  E  McGrory    MD
Contract Details
Hughston Clinic--LaGrange
Facility name
Provider ID
P000001111
NPI
1578506556
Tax ID
581155460
Effective Date
4/15/2010
Last Updated
9/22/2014
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
M
Exhibit ID
AM_140
Location Details
Address
107 Calumet Center Road
Lagrange, GA 30240
United States
County
Troup
Phone
7068843274 (Phone)
Billing Details
Address
P.O. Box 848249
Boston, MA 02284
Billing Phone
7063246661
Specialty Type
Surgery, Orthopedic
Map
Address