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Organization
SIERRA MEDICAL SERVICES, LLC
Active
Organization
SIERRA MEDICAL SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID A DE LASIERRA M.D. (OWNER)
(305) 610-8620
Entity
Organization
Contact information
Practice address
528 SOUTH 8TH STREET, GRIFFIN, GA 30224
(770) 467-1224
(770) 467-1225
Mailing address
P.O. BOX 28170, MACON, GA 31221-8170
(478) 254-5943
(478) 254-6093
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
056820
GA
Other
Enumeration date
06/24/2008
Last updated
11/10/2010
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