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General NPI Number Information
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NPI Number | 1487800199
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Entity Type | Organization
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Legal Business Name | MEDICAL SERVICES OF SOUTHERN GEORGIA, INC.
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Dates
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Enumeration Date | 08/13/2008
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Last Update Date | 10/17/2008
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Provider Practice Location Address
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Address Line | 3522 ASFORD DUNWOODY ROAD SUITE #407
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City | ATLANTA
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State | GA
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Zip | 30319-4207
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Country | US
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Telephone | 678-598-5519
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Fax |
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Provider Business Mailing Address
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Address Line | 3522 ASFORD DUNWOODY ROAD SUITE #407
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City | ATLANTA
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State | GA
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Zip | 30319-4207
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Country | US
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Telephone | 678-598-5519
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. RAUL GARCIA
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Credential |
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Telephone | 678-598-5519
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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