Organization
SOUTHERN KETAMINE AND WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN HARRISON IRONS MD (CO-OWNER)
(205) 202-9163
Entity
Organization
Contact information
Practice address
1932 LAUREL RD STE 1B, VESTAVIA HILLS, AL 35216-1939
(205) 202-9163
Mailing address
1932 LAUREL RD STE 1B, VESTAVIA HILLS, AL 35216-1939
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Enumeration date
01/11/2023
Last updated
03/15/2023
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