Organization
SOUTHSIDE PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAVI S IYER MD (PRESIDENT)
(678) 565-3300
Entity
Organization
Contact information
Practice address
151 NORTH PARK TRAIL, SUITE A, STOCKBRIDGE, GA 30281-7373
(678) 565-3300
(678) 565-3311
Mailing address
151 NORTH PARK TRAIL, SUITE A, STOCKBRIDGE, GA 30281-7373
(678) 565-3300
(678) 565-3311
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
042292
GA
Other
Enumeration date
05/21/2007
Last updated
10/14/2010
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