Organization
SOUTHLAND URO GYNECOLOGY ,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRANDON LUKE SEAGLE MD (PHYSICIAN)
(229) 474-6933
Entity
Organization
Contact information
Practice address
100 PLANTATION RIDGE DR APT D, AMERICUS, GA 31709-5282
(229) 474-6933
(888) 815-1851
Mailing address
100 PLANTATION RIDGE DR., UNIT D, AMERICUS, GA 31709-5282
(229) 474-6933
(888) 815-1851
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
—
—
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
Primary
—
—
2088F0040X
Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician
—
—
Other
Enumeration date
10/21/2021
Last updated
08/08/2024
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