Organization
BOARD OF REGENTS OF THE UNIVERSITY SYSTEM OF GEORGIA AND ON BEHALF....
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY RACKLIFFE (SENIOR VP FOR FINANCE AND ADMIN.)
(404) 413-3000
Entity
Organization
Contact information
Practice address
755 HANK AARON DR SW, ATLANTA, GA 30315-1120
(404) 413-4040
(404) 413-4041
Mailing address
755 HANK AARON DR SW, ATLANTA, GA 30315-1120
(404) 413-4040
(404) 413-4041
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
—
—
Other
Enumeration date
07/17/2019
Last updated
07/17/2019
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