Basic Information
| Provider Information | |||||||||
| NPI: | 1144545500 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SOUTHLAND MEDICAL SOLUTIONS OF OZARK, PL | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 5218 | ||||||||
| Address2: | |||||||||
| City: | NICEVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 325785218 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8508977244 | ||||||||
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| Practice Location | |||||||||
| Address1: | 126 HOSPITAL AVE | ||||||||
| Address2: | |||||||||
| City: | OZARK | ||||||||
| State: | AL | ||||||||
| PostalCode: | 363602018 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3347743955 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/29/2010 | ||||||||
| LastUpdateDate: | 09/07/2022 | ||||||||
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| AuthorizedOfficialLastName: | BELL | ||||||||
| AuthorizedOfficialFirstName: | LINDA | ||||||||
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| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 8508977244 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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| NPICertificationDate: | 09/07/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207PE0004X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Emergency Medicine | Emergency Medical Services |
No ID Information.