Organization
SOUTHERN HOSPITAL PHYSICIANS,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH R. WARNER (MANAGER)
(404) 313-0515
Entity
Organization
Contact information
Practice address
135 BLACKLAND CT E, MARIETTA, GA 30067
(404) 313-0515
(678) 540-5473
Mailing address
PO BOX 54424, ATLANTA, GA 30308-0424
(770) 458-1594
(770) 458-1596
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
047899
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000842916G
—
GA
Enumeration date
04/24/2007
Last updated
08/05/2025
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