Provider Demographics
NPI:1013302280
Name:LAURY, TORRANCE CHRISTOPHER (MD)
Entity type:Individual
Prefix:
First Name:TORRANCE
Middle Name:CHRISTOPHER
Last Name:LAURY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4500 N SHALLOWFORD RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:DUNWOODY
Mailing Address - State:GA
Mailing Address - Zip Code:30338-6476
Mailing Address - Country:US
Mailing Address - Phone:404-778-6920
Mailing Address - Fax:404-778-6901
Practice Address - Street 1:4500 N SHALLOWFORD RD
Practice Address - Street 2:SUITE B
Practice Address - City:DUNWOODY
Practice Address - State:GA
Practice Address - Zip Code:30338
Practice Address - Country:US
Practice Address - Phone:404-778-6920
Practice Address - Fax:404-778-6901
Is Sole Proprietor?:No
Enumeration Date:2015-04-03
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA80948207QS0010X
390200000X
GA080948207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program