| Sunsouth Medical Center | |
|
1467 John Robert Dr Suite B Morrow GA 30260-1770 | |
| (614) 284-4848 | |
| (678) 759-8815 |
| Full Name | Sunsouth Medical Center |
|---|---|
| Speciality | Family Medicine |
| Location | 1467 John Robert Dr, Morrow, Georgia |
| Authorized Official Name and Position | Anthony Labady (PROVIDER) |
| Authorized Official Contact | 7702938050 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sunsouth Medical Center 1467 John Robert Dr Ste B Morrow GA 30260-1770 Ph: (770) 892-1543 | Sunsouth Medical Center 1467 John Robert Dr Suite B Morrow GA 30260-1770 Ph: (614) 284-4848 |
| NPI Number | 1689055469 |
|---|---|
| Provider Enumeration Date | 06/17/2015 |
| Last Update Date | 02/07/2019 |
| Medicare PECOS PAC ID | 3173837465 |
|---|---|
| Medicare Enrollment ID | O20150730012389 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689055469 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 003426 (Georgia) | Primary |
| Provider Name | Antony Labady |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962667915 PECOS PAC ID: 9032253349 Enrollment ID: I20100922000395 |
| Provider Name | Ike A Nwaobi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1417112475 PECOS PAC ID: 8224218391 Enrollment ID: I20110207000356 |
| Provider Name | Angelique S Young |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598160046 PECOS PAC ID: 5698091130 Enrollment ID: I20150227001763 |
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