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SOUTHERN CRESCENT PHYSICIANS GROUP INC NPI 1366841744


NPI Information

NPI: 1366841744
Provider Name: SOUTHERN CRESCENT PHYSICIANS GROUP, INC
Classification: Psychiatry & Neurology - 2084N0400X
Entity Type: Organization

Specialization: Neurology

CLIA Number: 11D0257984

Address:
3885 PRINCETON LAKES WAY SW
ATLANTA, GA
ZIP 30331
Phone: (770) 996-3190
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SOUTHERN CRESCENT PHYSICIANS GROUP, INC is a neurology psychiatry neurology in Atlanta, GA. The provider is a Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. SOUTHERN CRESCENT PHYSICIANS GROUP, INC NPI is 1366841744. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3885 PRINCETON LAKES WAY SW
ATLANTA, GA
ZIP 30331-589
Phone: (770) 996-3190
Fax: (770) 996-3529

The provider's authorized official is John Mcclain .
The authorized official title is Ceo and has the following contact phone number (770) 897-7056.

The CLIA number assigned to this NPI record is 11D0257984 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 8/21/2014 and was last updated on 8/21/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12084N0400XPsychiatry & NeurologyNeurology053450GEORGIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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