Organization
SOUTHERN RAD ONC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENT ARTHUR HARRIS MD (OWNER)
(404) 796-5898
Entity
Organization
Contact information
Practice address
809 SOUTH PARK STREET, CARROLLTON, GA 30117
(678) 801-8746
(678) 801-8746
Mailing address
809 SOUTH PARK STREET, CARROLLTON, GA 30117
(678) 801-8746
(678) 801-8746
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
—
—
Other
Enumeration date
06/18/2020
Last updated
06/18/2020
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