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1750 Laurel Street Columbia SC 29201 Ph 803 779-3378 Fx 803 779-3103 A Lexington Medical Center Physician Practice 21 Gateway Corners Park Suite 101 Columbia SC 29203 Ph 803 865-2122 Fx 803 865-1464 Irmo Medical Park 7033 St. Andrews Road Ph 803 936-7480 Fx 803 936-7481 LMCPetersonandPlante. I realize the authorization allows LMC Physician Practices to release any information to any of my insurers or physicians. Com Physician Network Authorization/Consent Form GENERAL AUTHORIZATION FOR...

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