Southland Adel Emergency Services, LLC.

Primary specialty

Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X

Legal business name

SOUTHLAND ADEL EMERGENCY SERVICES, LLC.

Practice address

706 N Parrish Ave
Adel, GA 31620-1511

Phone

(229) 977-6692

NPI assigned

Jun 20, 2011

Last updated

Aug 10, 2011By 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. Mark Allen Lee, MD

Title

President

Phone

(229) 200-4019

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1308528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312934400000",
    "number": "1861788762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 501",
            "city": "CAIRO",
            "state": "GA",
            "postal_code": "398280501",
            "telephone_number": "229-977-6692",
            "fax_number": "229-377-0058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "706 N PARRISH AVE",
            "city": "ADEL",
            "state": "GA",
            "postal_code": "316201511",
            "telephone_number": "229-977-6692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHLAND ADEL EMERGENCY SERVICES, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-20",
        "last_updated": "2011-08-10",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "229-200-4019",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2011; 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.