Provider Demographics
NPI:1609844810
Name:LAIRET, JULIO RAFAEL (DO)
Entity Type:Individual
Prefix:DR
First Name:JULIO
Middle Name:RAFAEL
Last Name:LAIRET
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2291 GRADY RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30097-5255
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:531 ASBURY CIR
Practice Address - Street 2:N340
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322-1006
Practice Address - Country:US
Practice Address - Phone:404-778-2624
Practice Address - Fax:404-778-2630
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA67237207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine