# SOUTHERN NEURODIAGNOSTICS LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568769974
- **Authorized official:** DARIN MELVIN NP (NP/OWNER)
- **Authorized official phone:** (229) 740-7663

## Contact information

- **Practice address:** 5357 SHILOH RD, HAHIRA, GA 31632-2321
- **Practice address phone:** (229) 740-7639
- **Practice address fax:** (884) 638-8738
- **Mailing address:** 5357 SHILOH RD, HAHIRA, GA 31632-2321
- **Mailing address phone:** (292) 740-7639
- **Mailing address fax:** (888) 463-8873

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 054374 | GA | Yes |

## Other

- **Enumeration date:** 02/21/2011
- **Last updated:** 07/27/2022