Organization
PRIME REGEN DECATUR
Active
Other names
Prime Regen Decatur LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RANDALL LEE HAUPT MHA (EXECUTIVE VICE PRESIDENT, SGI)
(470) 292-3820
Entity
Organization
Contact information
Practice address
2680 LAWRENCEVILLE HWY STE 101, DECATUR, GA 30033-2526
(470) 292-3820
Mailing address
2680 LAWRENCEVILLE HWY STE 101, DECATUR, GA 30033-2526
(470) 292-3820
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
—
—
Other
Enumeration date
09/23/2021
Last updated
10/29/2024
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