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Organization

MELISSA JADICK

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CHRISTINA RIOS (CREDENTIALING SPECIALIST)
(706) 854-2558
Entity
Organization

Contact information

Practice address
1303 DANTIGNAC ST, SUITE 2600, AUGUSTA, GA 30901-2775
(706) 854-2500
(706) 774-7209
Mailing address
1303 DANTIGNAC ST, SUITE 2600, AUGUSTA, GA 30901-2775
(706) 854-2500
(706) 774-7209

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
056877
GA

Other

Enumeration date
08/09/2006
Last updated
08/22/2020
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