Organization
SOUTHERN HEALTH CARE OF GEORGIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JERRY D BLACKMON (OWNER)
(770) 509-5920
Entity
Organization
Contact information
Practice address
2790 SANDY PLAINS RD, SUITE 202, MARIETTA, GA 30066-4373
(770) 509-5920
(770) 509-5922
Mailing address
2790 SANDY PLAINS RD, SUITE 202, MARIETTA, GA 30066-4373
(770) 509-5920
(770) 509-5922
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
08/31/2013
Last updated
08/31/2013
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