| NPI | 1245413715 |
|---|---|
| Former Legal Business Name | MED-SOUTH PRIMARY CARE |
| Entity Type | Organization |
| Authorized Contact | KELLY MARIE PADGETT Insurance COO Rdinator 770-506-0100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 047830) |
| Enumeration Date | 2007-12-07 |
| Last Update Date | 2015-12-14 |