National Provider Identifier Database

SOUTHERN PEDIATRIC CLINIC LLC
Pediatrics

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.


Contact Information

SOUTHERN PEDIATRIC CLINIC, LLC
406 M NORTHSIDE DRIVE
VALDOSTA, GA31602
Phone: 229-241-0059
Fax: 229-241-0059
Website:
Specialty Taxonomy Code
* Pediatrics 208000000X

* Indicates primary specialty

NPI Profile & details for SOUTHERN PEDIATRIC CLINIC, LLC

NPI Number 1982858767
Legal business name
LBN
SOUTHERN PEDIATRIC CLINIC, LLC
Authorized official CHARLENE BLACHE - (OWNER/PHYSICIAN)
Entity Organization
Organization subpart No
Enumeration date 11/06/2008
Last updated 02/03/2017 - About 9 years ago
Sole proprietor1 Not specified
Identifiers n/a

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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