Organization
SOUTHERN SURGICAL & MEDICAL,INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN WALLACE (PRESIDENT)
(404) 519-7224
Entity
Organization
Contact information
Practice address
95 PINE GROVE DR, LOCUST GROVE, GA 30248-2561
(404) 519-7224
Mailing address
1220 OLD JACKSON RD, LOCUST GROVE, GA 30248-2120
(770) 954-1186
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
423450
GA
Other
Enumeration date
07/10/2006
Last updated
08/22/2020
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