Medical school: LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN SHREVEPORT
Graduated: 1994
NPI: 1407849706
Practice Locations (1)
EAST GEORGIA HMA PHYSICIAN MANAGEMENT LLC
1497 FAIR RD, SUITE 102
STATESBORO, GA 304580823
9124861676
Source: CMS National Downloadable File, September 2026.