Organization
SOUTHERN CRESCENT PHYSICIANS GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN MCCLAIN (CEO)
(770) 897-7056
Entity
Organization
Contact information
Practice address
7813 SPIVEY STATION BLVD, SUITE 100, JONESBORO, GA 30236-2900
(770) 996-3190
Mailing address
11 UPPER RIVERDALE RD SW, RIVERDALE, GA 30274-2615
(770) 897-7056
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
016401
GA
2084N0400X
Neurology Physician
053450
GA
208600000X
Surgery Physician
Primary
072683
GA
Other
Enumeration date
08/25/2014
Last updated
08/25/2014
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