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Organization
SOUTH PATH, P.C.
Active
Organization
SOUTH PATH, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN C MULLINS M.D. (PRESIDENT)
(706) 434-4121
Entity
Organization
Contact information
Practice address
1520 N LEG RD, AUGUSTA, GA 30909-4332
(706) 722-1846
(706) 722-3323
Mailing address
1520 N LEG RD, AUGUSTA, GA 30909-4332
(706) 722-1846
(706) 722-3323
Taxonomy
Speciality
Code
Description
License number
State
207ZD0900X
Dermatopathology (Pathology) Physician
—
—
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
686556795A
—
GA
05
—
GPA941
—
SC
Enumeration date
03/27/2007
Last updated
01/12/2009
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