Organization
SOUTHERN CARDIOPULMONARY ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD S SIMMOS M.D. (PRESIDENT)
(706) 884-2641
Entity
Organization
Contact information
Practice address
1551 DOCTORS DR, BUILDING 200, LAGRANGE, GA 30240-4139
(706) 884-2641
(706) 884-2353
Mailing address
1551 DOCTORS DR, BUILDING 200, LAGRANGE, GA 30240-4139
(706) 884-2641
(706) 884-2353
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300021816A
—
GA
01
—
CB9006
RAILROAD MEDICARE
GA
Enumeration date
09/14/2005
Last updated
07/21/2022
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