Organization
INTEGRA CLINICAL SERVICES, LLC-GA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC NIXON (OWNER)
(844) 856-9355
Entity
Organization
Contact information
Practice address
135 RIVERSIDE PKWY SW, AUSTELL, GA 30168-7749
(844) 856-9355
(844) 856-9355
Mailing address
8063 WESTSIDE BLVD, FULTON, MD 20759-2464
(844) 856-9355
(844) 856-9355
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
—
—
261QH0700X
Hearing and Speech Clinic/Center
—
—
Other
Enumeration date
11/04/2020
Last updated
11/04/2020
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