Provider Demographics
NPI:1033606876
Name:LAING, CINDY GISSEL (DO)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:GISSEL
Last Name:LAING
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:CINDY
Other - Middle Name:GISSEL
Other - Last Name:FLORES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3369 WOODTREE LN
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30519-6944
Mailing Address - Country:US
Mailing Address - Phone:561-568-7706
Mailing Address - Fax:
Practice Address - Street 1:2161 W SPRING ST STE A
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:GA
Practice Address - Zip Code:30655-3196
Practice Address - Country:US
Practice Address - Phone:770-267-8464
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-17
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
GA86081207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty