Southern Medical Clinic, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

45908 Issued in GA

Legal business name

SOUTHERN MEDICAL CLINIC, LLC

Practice address

5329 N Henry Blvd
Stockbridge, GA 30281-3224

Phone

(404) 761-1550

Fax

(404) 761-1558

NPI assigned

Sep 28, 2012

Last updated

Sep 28, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Chirag R. Patel, MDNPI 1225008758

Title

President

Phone

(404) 761-1550

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Chirag R Patel, M.D.

  • Internal Medicine Physician
  • Stockbridge, GA
  • NPI 1225008758
  NPD Authorized official

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

{
    "created_epoch": "1348790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348790400000",
    "number": "1184975278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5329 N HENRY BLVD",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302813224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5329 N HENRY BLVD",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302813224",
            "telephone_number": "404-761-1550",
            "fax_number": "404-761-1558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN MEDICAL CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-28",
        "last_updated": "2012-09-28",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "CHIRAG",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "404-761-1550",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "45908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southern Crescent Plastic Surgery ASC
• Southern Crescent Plastic Surgery, PC
• Southern Crescent Women's Health Specialists (women's health specialists)
• Southern Crescent Womens Health Specialists at Eagle's Landing (Women's Health Specialists)
• Southern Medical Clinic LLC
• Southside Behavioral Health, Inc. (Behavioral Healthcare Solutions, Inc.)
• Southside Kidney Clinics, PC
• Southside Medical Center, Inc (Southside Medical Center -Stockbridge)
• Southside Pediatrics
• Southside Psychiatric Associates, P.C.

• Internal Medicine Physician in Stockbridge, GA
• Providers in Stockbridge, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2012; 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.