Southern Crescent Pediatrics Pc

LBN: Southern Crescent Pediatrics Pc
Southern Crescent Pediatrics Pc is an health care organization with primary practice located at 150 Medical Blvd Ste B, Stockbridge GA 30281-5053. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as the primary health care specialty. Southern Crescent Pediatrics Pc can be contacted via phone (770) 389-9944, or through Sherwood, Juan Jose via phone (770) 389-9944.

Contact Information

Primary practice address
150 Medical Blvd Ste B Stockbridge GA 30281-5053
Phone: (770) 389-9944
Fax: (770) 389-1973
Website:
Map and Directions
Authorized official contact:
Name: Sherwood, Juan Jose Doctor of Medicine (MD)
Phone: (770) 389-9944

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X

Profile Details

NPI number 1972595999
LBN Legal business name Southern Crescent Pediatrics Pc
DBA Doing business as
Authorized official Sherwood, Juan Jose Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Aug 16th, 2005
Last updated Sep 30th, 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 1972595999 NPPES
Other 265152691 CHAMPUS

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