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MED SOUTH ASSOCIATES PC 2 LLC NPI 1710017413


NPI Information

NPI: 1710017413
Provider Name: MED SOUTH ASSOCIATES PC 2 LLC
Classification: Internal Medicine - 207RG0300X
Entity Type: Organization

Specialization: Geriatric Medicine

Address:
6572 RIVER PARK DR
SUITE 102
RIVERDALE, GA
ZIP 30274
Phone: (404) 943-0205
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MED SOUTH ASSOCIATES PC 2 LLC is a geriatric medicine internal medicine in Riverdale, GA. The provider is an internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. MED SOUTH ASSOCIATES PC 2 LLC NPI is 1710017413. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

6572 RIVER PARK DR
SUITE 102
RIVERDALE, GA
ZIP 30274-214
Phone: (404) 943-0205

The provider's authorized official is Alicia Holden .
The authorized official title is Lead and has the following contact phone number (404) 943-0205.

The enumeration date for this NPI number is 3/6/2007 and was last updated on 8/22/2020.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RG0300XInternal MedicineGeriatric MedicineYes

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: 5/5/2024

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