Sgmp Southland Llc
Psychiatry Physician in Valdosta, GA(View on Map)
Legal Business Name
Sgmp Southland Llc
NPI Number
1447695085
NPI Type
Organization
Enumeration Date
05/09/2013
Specialties
(Taxonomies)Code
2084P0800X
261Q00000X
261QP2300X
Primary Taxonomy
Yes
No
No
Licenses
State
Georgia
License Number
59451
Contact
Information
Purpose
Mailing
Location
Address
PO BOX 1276
2209 PINEVIEW DR
City
Thomasville
Valdosta
State
GA
GA
Postal Code
31799-1276
31602-7316
Country
US
US
Telephone Number
(229) 236-0831
(229) 236-0831
Authorized Official
Name
Stephanie Fletcher
Title or Position
CFO
Telephone Number
(229) 236-0831
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 05/13/2022
Provider Address
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