Phoenixlaboratory Services LLC

Primary specialty

Physiological LaboratoryTaxonomy code 293D00000X

Legal business name

PHOENIXLABORATORY SERVICES LLC

Practice address

6126 Prestley Mill Rd Ste H
Douglasville, GA 30134-5624

Phone

(678) 715-2993

NPI assigned

Jul 11, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Jason Arnez Davis

Title

Principal

Phone

(678) 485-2233

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1531267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531267200000",
    "number": "1053897181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8345 MOSSYBROOK LN",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301358510",
            "telephone_number": "678-984-6227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6126 PRESTLEY MILL RD STE H",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301345624",
            "telephone_number": "678-715-2993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIXLABORATORY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-11",
        "last_updated": "2018-07-11",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "ARNEZ",
        "authorized_official_title_or_position": "PRINCIPAL",
        "authorized_official_telephone_number": "678-485-2233",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aeryn Mackensi Phillips, PHARMD
• Suzanne Phillips, LMT Cmldt, LMT, CMLDT
• Michelle Marie Phillips, LMT
• Ralesia Phillips
• Phoenix Wellness Group, LLC
• Physicans Pain Clinic of Douglasville PC
• Physicians Immediate Med of Douglasville, P.C.
• Physiotherapy Associates Inc
• Michael B Piansky, M.D.
• Daniel William Pidgeon Jr., D.C.

• Physiological Laboratory in Douglasville, GA
• Providers in Douglasville, GA by specialty
• Physiological Laboratory in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.