Provider Information for 1619589090
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JAMIE ELIZABETH LOUGH MS
Sex: Female
NPI: 1619589090
Last Updated: 2023-05-30
Certification Date: 2023-05-30
Certification Date: 2023-05-30
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1619589090 | ||||||||
| Enumeration Date | 2020-08-18 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 3643 WALTON WAY EXT BLDG 4 AUGUSTA, GA 30909-6677 United States Phone: 706-364-1404 | Fax: | ||||||||
| Primary Practice Address | 3643 WALTON WAY EXT BLDG 4 AUGUSTA, GA 30909-6677 United States Phone: 706-364-1404 | Fax: | ||||||||
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