Southern Crescent Ent, P.C.

LBN: Southern Crescent Ent, P.C.
Southern Crescent Ent, P.C. is an health care organization with primary practice located at 1101 Hospital Dr Suite 100A, Stockbridge GA 30281-9075. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Otolaryngology, Allopathic & Osteopathic Physicians / Otology & Neurotology. Allopathic & Osteopathic Physicians / Otolaryngology is the primary health care specialty. Southern Crescent Ent, P.C. can be contacted via phone (770) 474-7416, or through Elliott, Melissa Jean via phone (770) 474-7416.

Contact Information

Primary practice address
1101 Hospital Dr Suite 100A Stockbridge GA 30281-9075
Phone: (770) 474-7416
Fax: (770) 389-6210
Website:
Map and Directions
Authorized official contact:
Name: Elliott, Melissa Jean
Phone: (770) 474-7416

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X 039722 Georgia
Allopathic & Osteopathic Physicians / Otology & Neurotology 207YX0901X 046956 Georgia

Profile Details

NPI number 1841281391
LBN Legal business name Southern Crescent Ent, P.C.
DBA Doing business as
Authorized official Elliott, Melissa Jean
Entity Organization
Organization subpart 1 No
Enumeration date Nov 3rd, 2005
Last updated Nov 14th, 2011 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1841281391 NPPES
Georgia MEDICAID 00677553A

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