Organization
EDUCATION SYSTEM MANAGEMENT, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARROLL BRADDY M.D.,MBA (CEO)
(770) 892-5284
Entity
Organization
Contact information
Practice address
125 HIGHWAY 138, RIVERDALE, GA 30274
(770) 742-0265
(770) 742-0862
Mailing address
1115 MOUNT ZION RD, SUITE C, MORROW, GA 30260-2266
(770) 742-0265
(770) 742-0862
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
CSW003727
GA
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003148586A
—
GA
05
—
003168151A
—
GA
Enumeration date
12/12/2011
Last updated
01/06/2022
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