| Southern Neurology, Physical Medicine & Rehabilitation, Llc | |
|
4913 Lanes Pond Rd Valdosta GA 31601-1537 | |
| (229) 292-2074 | |
| Not Available |
| Full Name | Southern Neurology, Physical Medicine & Rehabilitation, Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 4913 Lanes Pond Rd, Valdosta, Georgia |
| Authorized Official Name and Position | Tommy Keith Bussey (PRACTICE MANAGER) |
| Authorized Official Contact | 2292922074 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Neurology, Physical Medicine & Rehabilitation, Llc 4913 Lanes Pond Rd Valdosta GA 31601-1537 Ph: (229) 292-2074 | Southern Neurology, Physical Medicine & Rehabilitation, Llc 4913 Lanes Pond Rd Valdosta GA 31601-1537 Ph: (229) 292-2074 |
| NPI Number | 1013544899 |
|---|---|
| Provider Enumeration Date | 03/24/2020 |
| Last Update Date | 03/24/2020 |
| Certification Date | 03/24/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013544899 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
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