Provider Demographics
NPI:1689055469
Name:LABADY MEDICAL ASSOCIATES LLC
Entity Type:Organization
Organization Name:LABADY MEDICAL ASSOCIATES LLC
Other - Org Name:SUNSOUTH MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:LABADY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-293-8050
Mailing Address - Street 1:1467 JOHN ROBERT DR STE B
Mailing Address - Street 2:
Mailing Address - City:MORROW
Mailing Address - State:GA
Mailing Address - Zip Code:30260-1770
Mailing Address - Country:US
Mailing Address - Phone:770-892-1543
Mailing Address - Fax:877-207-7955
Practice Address - Street 1:1467 JOHN ROBERT DR
Practice Address - Street 2:SUITE B
Practice Address - City:MORROW
Practice Address - State:GA
Practice Address - Zip Code:30260-1770
Practice Address - Country:US
Practice Address - Phone:614-284-4848
Practice Address - Fax:678-759-8815
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-17
Last Update Date:2019-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA003426207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty