Organization
SOUTH ATLANTA MEDICAL GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAKESH KOTHARI DC (CEO)
(678) 328-0577
Entity
Organization
Contact information
Practice address
2643 CALDWELL RD NE, ATLANTA, GA 30319-3118
(678) 328-0577
Mailing address
2643 CALDWELL RD NE, ATLANTA, GA 30319-3118
(678) 328-0577
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
CHIR007845
GA
207R00000X
Internal Medicine Physician
Primary
036662
GA
Other
Enumeration date
07/25/2011
Last updated
01/10/2012
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