Provider Demographics
NPI:1447530357
Name:RANSOM, MARY LASHON
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:LASHON
Last Name:RANSOM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 SONOMA WOOD TRL
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:GA
Mailing Address - Zip Code:30016-5997
Mailing Address - Country:US
Mailing Address - Phone:470-948-5748
Mailing Address - Fax:404-254-1831
Practice Address - Street 1:798 RAYS RD
Practice Address - Street 2:SUITE 106
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30083-3144
Practice Address - Country:US
Practice Address - Phone:678-755-4361
Practice Address - Fax:404-254-1831
Is Sole Proprietor?:No
Enumeration Date:2011-08-23
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor