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SOUTHERN HEALTHCARE ALLIANCE LLC NPI 1962991703


NPI Information

NPI: 1962991703
Provider Name: SOUTHERN HEALTHCARE ALLIANCE, LLC

Doing Business As: SOUTHERN NEUROLOGY, PHYSICAL MEDICINE & REHABILITATION

Classification: Psychiatry & Neurology - 2084N0400X
Entity Type: Organization

Specialization: Neurology

Address:
101-F W. NORTHSIDE DRIVE
VALDOSTA, GA
ZIP 31602
Phone: (229) 262-1981
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SOUTHERN HEALTHCARE ALLIANCE, LLC is a neurology psychiatry neurology in Valdosta, GA. The provider is a Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. SOUTHERN HEALTHCARE ALLIANCE, LLC NPI is 1962991703. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Southern Neurology, Physical Medicine & Rehabilitation.

The provider's business location address is:

101-F W. NORTHSIDE DRIVE
VALDOSTA, GA
ZIP 31602
Phone: (229) 262-1981
Fax: (229) 375-0392

The provider's authorized official is Sheri L Swader .
The authorized official title is Physician/owner and has the following contact phone number (229) 262-1981.

The enumeration date for this NPI number is 5/8/2018 and was last updated on 8/12/2020.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208100000XPhysical Medicine & RehabilitationNo
22084N0400XPsychiatry & NeurologyNeurologyYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1003229819AMEDICAIDGEORGIA
2003208546CMEDICAIDGEORGIA

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: 5/5/2024

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