Southern Crescent Physicians Group, Inc.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

072683 Issued in GA

Legal business name

SOUTHERN CRESCENT PHYSICIANS GROUP, INC.

Practice address

33 Upper Riverdale Rd SW
Suite 121
Riverdale, GA 30274-2626

Phone

(770) 897-7546

Fax

(770) 991-8521

NPI assigned

Aug 19, 2014

Last updated

Aug 19, 2014By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

John McClain

Title

Ceo

Phone

(770) 897-7546

Specialties & licenses 1

Addresses

Tax ID family

Southern Crescent Physicians Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Southern Crescent Physicians Group, Inc.

  • Surgery Physician
  • Jonesboro, GA
  • NPI 1174923478
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1408406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408406400000",
    "number": "1366841082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 UPPER RIVERDALE RD SW",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302742615",
            "telephone_number": "770-897-7056",
            "fax_number": "770-909-2169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 UPPER RIVERDALE RD SW",
            "address_2": "SUITE 121",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302742626",
            "telephone_number": "770-897-7546",
            "fax_number": "770-991-8521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN CRESCENT PHYSICIANS GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-19",
        "last_updated": "2014-08-19",
        "status": "A",
        "authorized_official_last_name": "MCCLAIN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "770-897-7546"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "GA",
            "license": "072683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southern Crescent Pediatrics PC
• Southern Crescent Physicians Group
• Southern Crescent Physicians Group, Inc
• Southern Crescent Physicians Group, Inc.
• Southern Crescent Physicians Group, Inc.
• Southern Crescent Physicians Group, Inc.
• Southern Crescent Radiation Oncology Center LLC
• Southern Heart Specialists, P.C.
• Southern Medical Products, Inc.
• Southern Pulmonary Care

• Surgery Physician in Riverdale, GA
• Providers in Riverdale, GA by specialty
• Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.