Southern Crescent Physicians Group, Inc.

LBN: Southern Crescent Physicians Group, Inc.
Southern Crescent Physicians Group, Inc. is an health care organization with primary practice located at 11 Upper Riverdale Rd Sw Terrace Level, Riverdale GA 30274-2615. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Neurological Surgery, Allopathic & Osteopathic Physicians / Neurology. Allopathic & Osteopathic Physicians / Neurology is the primary health care specialty. Southern Crescent Physicians Group, Inc. can be contacted via phone (770) 996-3190, or through Mclain, John via phone (770) 897-7546.

Contact Information

Primary practice address
11 Upper Riverdale Rd Sw Terrace Level Riverdale GA 30274-2615
Fax: (770) 996-3529
Website:
Authorized official contact:
Name: Mclain, John

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurological Surgery 207T00000X 053450 Georgia
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 028352 Georgia

Profile Details

NPI number 1588069900
LBN Legal business name Southern Crescent Physicians Group, Inc.
DBA Doing business as
Authorized official Mclain, John
Entity Organization
Organization subpart 1 No
Enumeration date Oct 28th, 2014
Last updated Jun 22nd, 2015 - about 11 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 1588069900 NPPES
Georgia MEDICAID 990103456A

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