Organization
PRIMARY MEDICAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LOUELINA M SOOD MD (MD)
(770) 471-9990
Entity
Organization
Contact information
Practice address
1287 HWY 138 SPUR, SUITE #8, JONESBORO, GA 30236
(770) 471-9990
(770) 471-4290
Mailing address
1287 HWY 138 SPUR, SUITE #8, JONESBORO, GA 30236
(770) 471-9990
(770) 471-4290
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
O21592
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000368046D
—
GA
05
—
010052858
—
GA
01
—
1575820000
DEPT OF LABOR
—
01
—
279682172
TRICARE
—
01
—
85001388G
GEORGIA BETTER HEALTH
—
01
—
DA2480
RAILROAD MEDICARE
—
01
—
P00039443
RAILROAD MEDICARE
—
Enumeration date
03/27/2006
Last updated
08/22/2020
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