Provider Demographics
NPI:1740353895
Name:HOMLAR, MARJORIE LYNOTT (MD)
Entity type:Individual
Prefix:
First Name:MARJORIE
Middle Name:LYNOTT
Last Name:HOMLAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:755 MOUNT VERNON HWY NE STE 310
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-4288
Mailing Address - Country:US
Mailing Address - Phone:404-252-3430
Mailing Address - Fax:404-843-9398
Practice Address - Street 1:755 MOUNT VERNON HWY NE STE 310
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-4288
Practice Address - Country:US
Practice Address - Phone:404-252-3430
Practice Address - Fax:404-843-9398
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA0127252085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology