Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Board of Regents of the University System of Georgia and on Behalf

Organization Sports Medicine (Family Medicine) Physician · NPI 1114570389

Board of Regents of the University System of Georgia and on Behalf is a Sports Medicine (Family Medicine) Physician in Atlanta, Georgia. Registered with an NPI since 2019.

In the registry since
2019

Practice location Address checks out

755 Hank Aaron Dr SW
Atlanta, GA 30315-1120
Phone: (404) 413-4040
Fax: (404) 413-4041
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Sports Medicine (Family Medicine) Physician (primary) Taxonomy 207QS0010X

Record details

NPI number1114570389
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jerry Rackliffe — Senior Vp For Finance And Admin. · (404) 413-3000
NPI enumeratedJuly 17, 2019
Last updated in NPPESJuly 17, 2019
Mailing address755 Hank Aaron Dr Sw, Atlanta, GA 30315-1120

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