Organization Active NPI

Southland Dodge Hospitalist Services LLC

  • Hospitalist Physician
  • Eastman, GA
National Provider Identifier
1346894334
Registry record updated Jul 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
Legal business name
SOUTHLAND DODGE HOSPITALIST SERVICES LLC
Practice address
901 Griffin Ave
Eastman, GA 31023-6784
Phone
(478) 448-4000
NPI assigned
Jul 29, 2019
Last updated
Jul 29, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2019

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

Authorized official

Name
Stephanie Fletcher
Title
Cfo
Phone
(229) 236-0831

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208M00000X Primary

Addresses

Primary practice location

901 Griffin Ave
Eastman, GA 31023-6784

Mailing address

100 S Madison St
Thomasville, GA 31792-5473
Phone (229) 236-0831

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Eastman

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1564358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564358400000",
    "number": "1346894334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 S MADISON ST",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317925473",
            "telephone_number": "229-236-0831",
            "fax_number": "229-236-0871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 GRIFFIN AVE",
            "city": "EASTMAN",
            "state": "GA",
            "postal_code": "310236784",
            "telephone_number": "478-448-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHLAND DODGE HOSPITALIST SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-29",
        "last_updated": "2019-07-29",
        "status": "A",
        "authorized_official_last_name": "FLETCHER",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "229-236-0831"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Hospitalist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Eastman",
            "affiliation": "N",
            "address_1": "901 Griffin Ave",
            "city": "Eastman",
            "state": "GA",
            "country_code": "US",
            "postal_code": "310236784",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Eastman, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2019; 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.