Provider Demographics
NPI:1649424144
Name:RST GROUP INC
Entity Type:Organization
Organization Name:RST GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARCO
Authorized Official - Middle Name:A
Authorized Official - Last Name:AYULO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:912-283-6152
Mailing Address - Street 1:6300 POWERS FERRY RD NW
Mailing Address - Street 2:SUITE 600-172
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-2919
Mailing Address - Country:US
Mailing Address - Phone:912-283-6152
Mailing Address - Fax:912-283-5264
Practice Address - Street 1:501 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:WAYCROSS
Practice Address - State:GA
Practice Address - Zip Code:31501-5316
Practice Address - Country:US
Practice Address - Phone:912-283-6152
Practice Address - Fax:912-283-5264
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-11
Last Update Date:2008-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty