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SOUTHERN MEDICAL MANAGEMENT LLC NPI 1114196557


NPI Information

NPI: 1114196557
Provider Name: SOUTHERN MEDICAL MANAGEMENT, LLC

Doing Business As: SOUTHERNMED PEDIATRICS HILLCREST

Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 42D2141062

Address:
424 OLD CHEROKEE RD
LEXINGTON, SC
ZIP 29072
Phone: (803) 520-9380
Get Directions

SOUTHERN MEDICAL MANAGEMENT, LLC is a pediatrics in Lexington, SC. The provider is 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. SOUTHERN MEDICAL MANAGEMENT, LLC NPI is 1114196557. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Southernmed Pediatrics Hillcrest.

The provider's business location address is:

424 OLD CHEROKEE RD
LEXINGTON, SC
ZIP 29072-972
Phone: (803) 520-9380
Fax: (803) 520-9380

The provider's authorized official is R. Kyle Guyton .
The authorized official title is Physician and has the following contact phone number (803) 520-5800.

The CLIA number assigned to this NPI record is 42D2141062 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 2/28/2008 and was last updated on 10/4/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatricsYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1GP4862MEDICAIDSOUTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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