Organization
SOUTHSIDE MEDICAL CARE II LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ALICIA HOLDEN (BILLING MANAGER)
(404) 943-0205
Entity
Organization
Contact information
Practice address
6325 SHANNON PKWY, SUITE D, UNION CITY, GA 30291-1538
(404) 943-0205
(404) 943-0209
Mailing address
5909 PEACHTREE DUNWOODY RD NE, SUITE 900, ATLANTA, GA 30328-8102
(404) 943-0205
(404) 943-0209
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
GA
Other
Enumeration date
06/22/2009
Last updated
06/22/2009
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