Organization
SOUTHERN CRESEANT SURGICAL ASSISTANTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD JENNINGS (OWNER)
(770) 985-4257
Entity
Organization
Contact information
Practice address
7615 MOUNT ZION BLVD, JONESBORO, GA 30236-7934
(770) 985-4257
Mailing address
PO BOX 162749, ATLANTA, GA 30321-2749
(770) 985-4257
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
04/23/2007
Last updated
08/22/2020
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