Organization
JACKSON DIALYSIS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BABATUNDE FARIYIKE (MEDICAL DIRECTOR)
(706) 647-8065
Entity
Organization
Contact information
Practice address
794 MCDONOUGH RD, SUITE 108, JACKSON, GA 30233-1572
(770) 504-9525
Mailing address
PO BOX 888, JACKSON, GA 30233-0019
(770) 504-9525
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
GA
Other
Enumeration date
05/23/2007
Last updated
08/22/2020
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