Organization
INDIAN RIVER EMERGENCY GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PRESTON WILLIAMS SMITH (CHIEF REVENUE OFFICER)
(770) 874-5400
Entity
Organization
Contact information
Practice address
17240 CORTEZ BLVD, BROOKSVILLE, FL 34601-8921
(352) 796-5111
Mailing address
5665 NEW NORTHSIDE DR, SUITE 320, ATLANTA, GA 30328-5831
(770) 874-5400
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Enumeration date
03/02/2016
Last updated
03/02/2016
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