Provider Demographics
NPI:1639220965
Name:MARCH, LOIS RAE (MD)
Entity Type:Individual
Prefix:MS
First Name:LOIS
Middle Name:RAE
Last Name:MARCH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 E 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:CORDELE
Mailing Address - State:GA
Mailing Address - Zip Code:31015-3208
Mailing Address - Country:US
Mailing Address - Phone:229-271-4656
Mailing Address - Fax:229-271-4654
Practice Address - Street 1:910 N 5TH ST
Practice Address - Street 2:
Practice Address - City:CORDELE
Practice Address - State:GA
Practice Address - Zip Code:31015-3254
Practice Address - Country:US
Practice Address - Phone:229-271-4623
Practice Address - Fax:229-276-3640
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA046310207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
B08129Medicare UPIN
GA04BDCTBMedicare PIN