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Southern Crescent Neurological Clinic,pc
Neurology Physician in Fayetteville, Georgia
NPI 1013052182

Southern Crescent Neurological Clinic,pc is a Neurology Physician based in Fayetteville, GA and is specialized in Neurology. Southern Crescent Neurological Clinic,pc practices in Fayetteville, GA. The NPI Number for Southern Crescent Neurological Clinic,pc is 1013052182 and holds a License No. 031058 (Georgia).

The current practice location address for Southern Crescent Neurological Clinic,pc is 1250 Highway 54 W, Fayetteville, GA and can be reached out via phone at 770-719-2965 and via fax at 770-719-2963.

Location: 1250 Highway 54 W, Fayetteville, GA, 30214-4545
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1013052182
Provider Name
Southern Crescent Neurological Clinic,pc
Credential
Provider Entity Type
Organization
Address
1250 Highway 54 W, Fayetteville, GA, 30214-4545
Phone Number
770-719-2965
Fax Number
770-719-2963
Provider Enumeration Date
02/20/2007
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
000406795D 05 GA
GRP2807 01 GA MEDICARE FACILITY ID
institution
Provider Business Practice Location Address Details
Address
1250 Highway 54 W
City
Fayetteville
State
Georgia
Zip
30214-4545
Phone Number
770-719-2965
Fax Number
770-719-2963
person
Provider Business Mailing Address Details
Address
1250 Highway 54 W
City
Fayetteville
State
Georgia
Zip
30214-4545
Phone Number
770-719-2965
Fax Number
770-719-2963
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Psychiatry & Neurology
Speciality
Neurology
Taxonomy
2084N0400X
License No.
031058 (Georgia)
Definition
A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.
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