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SOUTHERN MEDICAL HOLDING CORPORATION NPI 1558340083


NPI Information

NPI: 1558340083
Provider Name: SOUTHERN MEDICAL HOLDING CORPORATION

Doing Business As: SOUTHERN MEDICAL CORPORATION

Classification: Specialist/Technologist Cardiovascular - 246XS1301X
Entity Type: Organization

Specialization: Sonography

Address:
12133 INDUSTRIPLEX BLVD
BATON ROUGE, LA
ZIP 70809
Phone: (225) 756-5239
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SOUTHERN MEDICAL HOLDING CORPORATION is a sonography specialist technologist cardiovascular in Baton Rouge, LA. SOUTHERN MEDICAL HOLDING CORPORATION NPI is 1558340083. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Southern Medical Corporation.

The provider's business location address is:

12133 INDUSTRIPLEX BLVD
BATON ROUGE, LA
ZIP 70809-129
Phone: (225) 756-5239
Fax: (225) 752-2614

The provider's authorized official is David P Melancon .
The authorized official title is Coo/cfo and has the following contact phone number (225) 756-5239.

The enumeration date for this NPI number is 1/12/2006 and was last updated on 6/28/2013.


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
1246XS1301XSpecialist/Technologist CardiovascularSonography170011032LOUISIANAYes

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
1C3563OTHERLOUISIANABLUE CROSS PROV.NUMBER
2630001714MEDICARE ID-TYPE UNSPECIFIEDLOUISIANARAIL ROAD X-RAY PROV.NO.
3001013514MEDICARE ID-TYPE UNSPECIFIEDMISSOURIPROVIDER NUMBER
4470001731MEDICARE ID-TYPE UNSPECIFIEDLOUISIANARAIL ROAD PROVIDER NUMBER
51121894MEDICAIDLOUISIANA
6506047901MEDICAIDMISSOURI
75C440MEDICARE ID-TYPE UNSPECIFIEDLOUISIANAPROVIDER NUMBER

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: 4/28/2024

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