Organization
SOUTHERN CRESCENT PHYSICIANS GROUP, INC.
Active
Organization
SOUTHERN CRESCENT PHYSICIANS GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN MCCLAIN (CEO)
(770) 597-7056
Entity
Organization
Contact information
Practice address
33 UPPER RIVERDALE RD SW, SUITE 17, RIVERDALE, GA 30274-2626
(770) 897-7056
(770) 909-2169
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
Primary
016401
GA
208600000X
Surgery Physician
072683
GA
Other
Enumeration date
08/19/2014
Last updated
08/19/2014
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