# SOUTHERN CRESEANT SURGICAL ASSISTANTS

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

## Provider details

- **NPI number:** 1841418225
- **Authorized official:** RONALD JENNINGS (OWNER)
- **Authorized official phone:** (770) 985-4257

## Contact information

- **Practice address:** 7615 MOUNT ZION BLVD, JONESBORO, GA 30236-7934
- **Practice address phone:** (770) 985-4257
- **Mailing address:** PO BOX 162749, ATLANTA, GA 30321-2749
- **Mailing address phone:** (770) 985-4257

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363AS0400X | Surgical Physician Assistant | — | NULL | Yes |
| 363AS0400X | Surgical Physician Assistant | — | — | Yes |

## Other

- **Enumeration date:** 04/23/2007
- **Last updated:** 08/22/2020