Organization
SLEEP LABS OF THE DEEP SOUTH LLC
Active
Other names
Deep South Sleep Disorders Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MS. REBECCA ESTELLE GAYLORD (OFFICE MANAGER)
(225) 925-3357
Entity
Organization
Contact information
Practice address
13702 COURSEY BOULEVARD, BUILDING 4 SUITE A, BATON ROUGE, LA 70817-1370
(225) 925-3357
(225) 924-9863
Mailing address
382 B CARRIAGE HOUSE DRIVE, JACKSON, TN 38305-2299
(731) 664-8716
(731) 664-8932
Taxonomy
Speciality
Code
Description
License number
State
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G6949
BCBS LA
—
Enumeration date
04/13/2006
Last updated
05/31/2012
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