Organization
MED SOUTH ASSOCIATES PC 2 LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALICIA HOLDEN ACCOUNTING (LEAD)
(404) 943-0205
Entity
Organization
Contact information
Practice address
6572 RIVER PARK DR, SUITE 102, RIVERDALE, GA 30274-2214
(404) 943-0205
Mailing address
PO BOX 468329, ATLANTA, GA 31146-8329
(404) 943-0205
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
—
—
Other
Enumeration date
03/06/2007
Last updated
08/22/2020
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