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Organization

SPORTS MEDICINE SOUTH, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. GARY A LEVENGOOD M.D. (OWNER)
(770) 237-3475
Entity
Organization

Contact information

Practice address
1900 RIVERSIDE PKWY, LAWRENCEVILLE, GA 30043-5925
(770) 237-3475
(770) 237-3756
Mailing address
1900 RIVERSIDE PKWY, LAWRENCEVILLE, GA 30043-5925
(770) 237-3475
(770) 237-3756

Taxonomy

Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
040138
GA

Other

Enumeration date
01/17/2008
Last updated
01/17/2008
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