Southern Crescent Pediatrics Pc
Pediatrics
Southern Crescent Pediatrics Pc is a Ellenwood, Georgia based Pediatric center with medical specialization in
General Pediatrics.
It is located at
191 Fairview Rd, Ellenwood, Georgia - 30294-2722. They can be contacted on phone at
770-389-5500 and fax number 770-389-4959.
NPI number (Unique professional ID) for Southern Crescent Pediatrics Pc is
1437145950 which was assigned by NPPES on 20 Sep, 2005 and it was last updated on 22 Aug, 2020.
Southern Crescent Pediatrics Pc is a pediatrician who is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Complete Profile:
Southern Crescent Pediatrics Pc basic information including their official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics |
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| Provider Name : | Southern Crescent Pediatrics Pc |
|---|
Business Address:
Southern Crescent Pediatrics Pc address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 191 Fairview Rd
Ellenwood, GA, 30294-2722
United States |
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| Phone Number : | 770-389-5500 |
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| Fax Number : | 770-389-4959 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1437145950 |
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| NPI Entity Type : | Organization |
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| First Enrolment Date : | 20 Sep, 2005 |
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| Last Updated On : | 22 Aug, 2020 |
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Authorized Official Details:
Officially authorized person to contact for any management issues or complaints of this organization are as below. Person's position and contact details are as mentioned below.
| Authorized Official Name : | Juanjose Sherwood |
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| Authorized Official Credential : | MD |
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| Official Title or Position : | PRESIDENT |
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| Phone Number : | 770-389-9944 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Southern Crescent Pediatrics Pc are as mentioned. Primary taxonomy code for Southern Crescent Pediatrics Pc is
208000000X (Pediatrics).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 208000000X | Pediatrics | Yes | | |
Legacy Identifiers:
Other legacy medical identifiers of Southern Crescent Pediatrics Pc such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| 7802 | Other | | KAISER POS |
| 0526682 | Other | | AETNA SELECT/US HEALTHC |
| 276714 | Other | | BCBS |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 150 Medical Blvd, Ste B
Stockbridge, GA, 30281-5053
United States |
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| Phone Number : | 770-389-9944 |
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| Fax Number : | 770-389-1973 |
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Business Location:
Patients can refer following map for directions to
Southern Crescent Pediatrics Pc practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES.