Organization
GEORGIA NEPHROLOGY, LLC
Active
Organization
GEORGIA NEPHROLOGY, LLC
Active
Other names
SOUTH DEKALB DIALYSIS CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW DIXON MD (OWNER/CEO)
(770) 981-0558
Entity
Organization
Contact information
Practice address
2801 CANDLER RD, SUITE 203, DECATUR, GA 30034-1423
(404) 241-0402
(404) 328-0232
Mailing address
2801 CANDLER RD, SUITE 203, DECATUR, GA 30034-1423
(404) 241-0402
(404) 328-0232
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
ESRD001212
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00963168A/B
—
GA
Enumeration date
06/12/2006
Last updated
08/22/2020
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