Healthcare Provider Details

I. General information

NPI: 1568616860
Provider Name (Legal Business Name): APOLLOMD GROUP SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2008
Last Update Date: 03/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 S 8TH ST
GRIFFIN GA
30224-4213
US

IV. Provider business mailing address

5665 NEW NORTHSIDE DR NW STE 320
ATLANTA GA
30328-5834
US

V. Phone/Fax

Practice location:
  • Phone: 770-228-2721
  • Fax:
Mailing address:
  • Phone: 770-874-5400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ROGER P MURRAY
Title or Position: COO
Credential:
Phone: 770-874-5400