Organization
SOUTHERN GASTROENTEROLOGY SPECIALISTS, P.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ARUNA R PRAKASH B.SC (SECRETORY)
(770) 692-0100
Entity
Organization
Contact information
Practice address
4865 BILL GARDNER PKWY, LOCUST GROVE, GA 30248-3644
(770) 692-0100
Mailing address
4865 BILL GARDNER PKWY, LOCUST GROVE, GA 30248-3644
(770) 692-0100
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
09/11/2006
Last updated
11/12/2010
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