Southern Crescent Pediatrics Pc

LBN: Southern Crescent Pediatrics Pc
Southern Crescent Pediatrics Pc is an health care organization with primary practice located at 6584 Professional Pl Ste C, Riverdale GA 30274-4942. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as the primary health care specialty. Southern Crescent Pediatrics Pc can be contacted via phone (770) 996-9225, or through Sherwood, Juan Jose via phone (770) 389-9944.

Contact Information

Primary practice address
6584 Professional Pl Ste C Riverdale GA 30274-4942
Phone: (770) 996-9225
Fax: (770) 997-6812
Website:
Map and Directions
Authorized official contact:
Name: Sherwood, Juan Jose Doctor of Medicine (MD)
Phone: (770) 389-9944

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X

Profile Details

NPI number 1548252562
LBN Legal business name Southern Crescent Pediatrics Pc
DBA Doing business as
Authorized official Sherwood, Juan Jose Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Aug 16th, 2005
Last updated Aug 22nd, 2020 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548252562 NPPES
Other 7802 KAISER POS
Other 0526682 KAISER POS
Other 7802 KAISER POS
Other 1202577 KAISER POS
Other 276714 KAISER POS
Other S06119 KAISER POS

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