Provider Demographics
NPI:1154329928
Name:LAMAN, KIRK B (DO)
Entity Type:Individual
Prefix:DR
First Name:KIRK
Middle Name:B
Last Name:LAMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:15 REINHARDT COLLEGE PKWY
Mailing Address - Street 2:SUITE 110
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30114-5257
Mailing Address - Country:US
Mailing Address - Phone:770-720-2383
Mailing Address - Fax:770-479-8871
Practice Address - Street 1:15 REINHARDT COLLEGE PKWY
Practice Address - Street 2:SUITE 110
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30114-5257
Practice Address - Country:US
Practice Address - Phone:770-720-2383
Practice Address - Fax:770-479-8871
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2016-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA075277207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIE49515Medicare UPIN
MIOC36345028Medicare ID - Type Unspecified
MI4579015Medicaid