SOUTH GEORGIA PEDIATRICS, P.C.
Ambulatory Health at Brampton Ave, Statesboro, GA

License number
Georgia 044756
Category
Medical Practice
Type
Specialist
License number
Georgia APPLIED FOR
Category
Ambulatory Health
Type
Clinic/Center
Owner
Name: RAO TULASI IMMANENI M.D., F.A.A.P.
Title: CEO
Phone: (912) 247-0409
Address
Address
1230 Brampton Ave, Statesboro, GA 30458
National Provider ID: 1578797627
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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SOUTH GEORGIA PEDIATRICS, PC

Statesboro, GA

Industry:
Medical Doctor's Office
Registration:
Apr 2, 2009
Addresses:
1230 Brampton Ave, Statesboro, GA 30459 (Physical)
PO Box 327, Statesboro, GA 30459
Statesboro, GA 30459
State ID:
09024098
Business type:
Domestic Professional Corporation
Pediatricss:
Rao Immaneni (Secretary, Chief Executive Officer, Medical Doctor, Principal), 1230 Brampton Ave, Statesboro, GA 30458 (Physical),Patricia Moore (Nurse Practitioner),Cheyenne E. Shaw (Receptionist Secretary),...

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