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Organization
GA GASTRO LLC
Active
Organization
GA GASTRO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ARUNA REDDY PRAKASH (ADMINISTRATOR)
(404) 641-3345
Entity
Organization
Contact information
Practice address
4865 BILL GARDNER PKWY, LOCUST GROVE, GA 30248-3644
(404) 641-3345
Mailing address
1100 HOSPITAL DR STE 200, STOCKBRIDGE, GA 30281-6381
(770) 692-0100
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
NULL
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Enumeration date
04/14/2021
Last updated
04/14/2021
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