Most Relevant Information
Provider Data
| NPI Number: | 1003699240 |
| Provider Name: | BARBARA MALLORY LANE NP |
| Entity Type: | Individual |
| Taxonomy Code: | 207NS0135X |
| Specialty: | Dermatology |
| License Number: | RN203145 |
Most Important Dates
| Enumeration Date: | 08/14/2023 |
| Last Updated: | 10/26/2023 |
Provider Practice Location
4233 CAMELOT CROSSING
VALDOSTA
GA
316026926
Practice Location Phone/Fax
| Phone: | 2294694383 |
| Fax: | 2294694584 |
Provider Mailing Location
4233 CAMELOT CROSSING
VALDOSTA
GA
316026926
Provider Mailing Phone/Fax
| Phone: | 2294694383 |
| Fax: |