Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Maurice Edwards-Lackey, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1598269953

Maurice Edwards-Lackey, MD is an Emergency Medicine in Lagrange, Georgia. Graduated from Morehouse School of Medicine in 2018, 8 years ago. Practices with The Bortolazzo Group, LLC, a 92-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
8
Trained at
Morehouse School of Medicine
Licensed in
GA
In the registry since
2018
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1514 Vernon Rd
Lagrange, GA 30240-4131
Phone: (706) 691-9671
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 677 Church St Ne, Marietta, GA 30060-1101 — (706) 691-9671

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence 87734 (GA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1598269953
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 21, 2018
Last updated in NPPESMarch 30, 2021
Certification dateMarch 30, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyEMERGENCY MEDICINE
Medical schoolMOREHOUSE SCHOOL OF MEDICINE
Graduated 2018 (8 years in practice)
Group practice The Bortolazzo Group, Llc — 92 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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