# SOUTH ATLANTA PRIMARY CARE PC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1710183454
- **Authorized official:** DR. MICHAEL ANGEL DICRISTINA MD (PHYSICIAN OWNER)
- **Authorized official phone:** (770) 968-7933

## Contact information

- **Practice address:** 6568A TARA BLVD, JONESBORO, GA 30236-1228
- **Practice address phone:** (770) 968-7933
- **Practice address fax:** (770) 968-6521
- **Mailing address:** 6568A TARA BLVD, JONESBORO, GA 30236-1228
- **Mailing address phone:** (770) 968-7933
- **Mailing address fax:** (770) 968-6521

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 173000000X | Legal Medicine | 022223 | GA | Yes |

## Other

- **Enumeration date:** 06/21/2007
- **Last updated:** 08/22/2020