Southern Pediatric Clinic, Llc

LBN: Southern Pediatric Clinic, Llc
Southern Pediatric Clinic, Llc is an health care organization with primary practice located at 406 M Northside Drive , Valdosta GA 31602. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as the primary health care specialty. Southern Pediatric Clinic, Llc can be contacted via phone (229) 241-0059, or through Blache, Charlene C via phone (229) 241-0059.

Contact Information

Primary practice address
406 M Northside Drive Valdosta GA 31602
Phone: (229) 241-0059
Fax: (229) 241-0059
Website:
Map and Directions
Authorized official contact:
Name: Blache, Charlene C Doctor of Medicine (MD)
Phone: (229) 241-0059

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X

Profile Details

NPI number 1982858767
LBN Legal business name Southern Pediatric Clinic, Llc
DBA Doing business as
Authorized official Blache, Charlene C Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Nov 6th, 2008
Last updated Feb 3rd, 2017 - about 9 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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