Organization
SLEEP MANAGEMENT CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEVIN DONALDSON (PRESIDENT)
(662) 349-9802
Entity
Organization
Contact information
Practice address
6858 SWINNEA RD, SOUTHAVEN, MS 38671-9493
(662) 349-9802
Mailing address
6858 SWINNEA ROAD, 1B RUTLAND PLACE, SOUTHAVEN, MS 38671-5876
(901) 461-8009
(662) 349-9810
Taxonomy
Speciality
Code
Description
License number
State
207RS0012X
Sleep Medicine (Internal Medicine) Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
APN06640
MS
Other
Enumeration date
12/31/2015
Last updated
03/21/2024
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