Southern Crescent Primary Care

NPI #1922267129 in Jonesboro, Georgia

Provider Information

NPI Number: 1922267129
Entity Type: Organization
Organization Name: Southern Crescent Primary Care
Primary Specialty: Internal Medicine
Enumeration Date: Jun 3, 2008
Last Updated: Jun 3, 2008

Practice Location

Address: 7823 SPIVEY STATION BLVD
Address 2: SUITE 210
City: Jonesboro
State: Georgia
ZIP Code: 30236-2886
Phone: (678) 610-2916

Authorized Official

Name: JOHN OLUBUSOLA OGUNDIPE, MD,PHD,CMD
Title: PHYSICIAN/PRESIDENT
Phone: (678) 610-2916

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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