Organization
MED-SOUTH PRIMARY CARE
Active
Other names
MED-SOUTH PRIMARY CARE
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KELLY MARIE PADGETT (INSURANCE COORDINATOR)
(770) 506-0100
Entity
Organization
Contact information
Practice address
1240 EAGLES LANDING PARKWAY, SUITE 100, STOCKBRIDGE, GA 30281
(770) 506-0100
(770) 507-2597
Mailing address
1240 EAGLES LANDING PARKWAY, SUITE 100, STOCKBRIDGE, GA 30281
(770) 506-0100
(770) 507-2597
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
047830
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00932357A
—
GA
Enumeration date
12/07/2007
Last updated
12/14/2015
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