Organization
SOUTHERN GASTROENTEROLOGY& HEPATOLOGY CONSULTANTS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUDHAKAR JONNALAGADDA MD (OFFICER)
(912) 384-7275
Entity
Organization
Contact information
Practice address
300 SHIRLEY AVE, DOUGLAS, GA 31533-2332
(912) 384-7275
Mailing address
300 SHIRLEY AVENUE, DOUGLAS, GA 31533-2332
(912) 384-7275
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
GA041589
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10BBCDX
MEDICARE
GA
Enumeration date
11/14/2007
Last updated
12/08/2010
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