Organization
SOUTHERN CRESCENT PHYSICIANS GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN MCCLAIN (CEO)
77089770566
Entity
Organization
Contact information
Practice address
325 N JEFF DAVIS DR, FAYETTEVILLE, GA 30214-1627
(770) 461-1337
Mailing address
11 UPPER RIVERDALE RD SW, RIVERDALE, GA 30274-2615
(770) 897-7056
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
072414
GA
Other
Enumeration date
08/19/2014
Last updated
08/19/2014
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