Organization
SOUTHLAND CONSOLIDATED EMERGENCY SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE FLETCHER (CFO)
(229) 236-0831
Entity
Organization
Contact information
Practice address
4 MEDICAL DR, ELBERTON, GA 30635-1897
(706) 283-3151
Mailing address
100 S MADISON ST, THOMASVILLE, GA 31792-5473
(292) 236-0831
(229) 236-0871
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9999999
—
GA
Enumeration date
03/26/2015
Last updated
06/11/2019
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