Organization
SOUTH GEORGIA CARDIOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRY BRUCE TRI M.D (PRESEDENT)
(229) 245-1000
Entity
Organization
Contact information
Practice address
2301 N ASHLEY ST, VALDOSTA, GA 31602-2620
(229) 245-1000
(229) 242-2788
Mailing address
2301 N ASHLEY ST, VALDOSTA, GA 31602-2620
(229) 245-1000
(229) 242-2788
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
038991
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00972353A
—
GA
Enumeration date
07/13/2006
Last updated
07/21/2022
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