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SOUTH LAKE PEDIATRICS NPI 1619203791


NPI Information

NPI: 1619203791
Provider Name: SOUTH LAKE PEDIATRICS

: SOUTH LAKE PEDIATRICS

Classification: Pediatrics - 208000000X
Entity Type: Organization
Address:
9908 COULOAK DR
STE 103
CHARLOTTE, NC
ZIP 28216
Phone: (704) 801-2025
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SOUTH LAKE PEDIATRICS is a pediatrics in Charlotte, NC. 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. SOUTH LAKE PEDIATRICS NPI is 1619203791. The provider is registered as an organization entity type and is a single specialty group.
The provider South Lake Pediatrics.

The provider's business location address is:

9908 COULOAK DR
STE 103
CHARLOTTE, NC
ZIP 28216-678
Phone: (704) 801-2025

The provider's authorized official is Thomas Laymon .
The authorized official title is Senior Vice President and has the following contact phone number (704) 446-8250.

The enumeration date for this NPI number is 10/26/2009 and was last updated on 7/16/2020.


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

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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