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Organization
SHIVASHANKER PC
Active
Organization
SHIVASHANKER PC
Active
Other names
PARKWAY MEDICAL CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VALENCIA W FLOURNOY (ADMINISTRATOR)
(404) 579-2188
Entity
Organization
Contact information
Practice address
7695 HIGHPOINT DR, JONESBORO, GA 30236
(404) 361-3100
(404) 361-3141
Mailing address
406 FOREST PKWY, STE A, FOREST PARK, GA 30297-2190
(404) 361-3100
(404) 361-3141
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
034881
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000477287K
—
GA
Enumeration date
01/13/2009
Last updated
01/13/2009
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