Organization
SOUTHERN MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOEL KOPPENHAVER (PRESIDENT BILLING SERVICES)
(770) 874-5400
Entity
Organization
Contact information
Practice address
3400 HIGHWAY 78 E, JASPER, AL 35501-8956
(205) 387-4187
Mailing address
PO BOX 409746, ATLANTA, GA 30384-9746
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Enumeration date
05/31/2006
Last updated
07/21/2022
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