Organization
SOUTHERN CRESCENT MEDICAL CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL THOMAS HARTPENCE (OWNER)
(770) 460-7613
Entity
Organization
Contact information
Practice address
696 MOUNT ZION RD, SUITE C-4, JONESBORO, GA 30236-1597
(770) 968-1746
(770) 968-0727
Mailing address
530 BIRKDALE DR, FAYETTEVILLE, GA 30215-2724
(770) 460-7613
(770) 968-0727
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
GA
207R00000X
Internal Medicine Physician
Primary
—
GA
Other
Enumeration date
01/04/2007
Last updated
09/11/2025
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