Basic Information
| Provider Information | |||||||||
| NPI: | 1235381468 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SOUTHLAND HOSPITALIST SERVICES AT EUFAULA, 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: | 820 W WASHINGTON ST | ||||||||
| Address2: | |||||||||
| City: | EUFAULA | ||||||||
| State: | AL | ||||||||
| PostalCode: | 360271822 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3346887000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/21/2008 | ||||||||
| LastUpdateDate: | 09/07/2022 | ||||||||
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| AuthorizedOfficialLastName: | HART | ||||||||
| AuthorizedOfficialFirstName: | PAUL | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8508977244 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 09/07/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.