Individual
GEOFFREY LEROY SOUTHMAYD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
SCHOOL OF MEDICINE GME OFC, 1648 PIERCE DR., SUITE 327, ATLANTA, GA 30322-0001
(404) 727-3097
Mailing address
1700 HOSPITAL SOUTH DR STE 409, AUSTELL, GA 30106-8159
(770) 732-9100
(678) 819-0359
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
5823
GA
207RI0011X
Interventional Cardiology Physician
Primary
74373
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/26/2012
Last updated
10/01/2020
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