Organization
REGENCY HEALTH ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DIANE R ALEXANDER (CEO)
(770) 414-8005
Entity
Organization
Contact information
Practice address
374 OSPREY PT, STONE MOUNTAIN, GA 30087-6163
(770) 413-1197
Mailing address
PO BOX 870614, STONE MOUNTAIN, GA 30087-0016
(770) 413-1197
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
033908
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
85000886G
—
GA
Enumeration date
12/18/2006
Last updated
09/01/2010
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