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Contact Information

SOUTHERN PEDIATRIC CLINIC, LLC
406 M NORTHSIDE DRIVE
VALDOSTA, GA31602
 Phone: 229-241-0059
 Fax: 229-241-0059
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

208000000X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for SOUTHERN PEDIATRIC CLINIC LLC · (Female)

NPI # 1982858767
Status Active
Credentials
Entity Individual
Enumeration date 11/06/2008
Last updated 02/03/2017 - About 9 years ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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