Southern Pediatric Clinic

  • 1104297720 NPI Number
  • |
  • Actived: 8 years ago
  • |
Southern Pediatric Clinic is a health care provider based in Shreveport, LA. The NPI Number is 1104297720 and it has been active since 8 years ago. The specialty is Health Service, providing comprehensive mental health services to individuals, families, and communities. If you are looking for Health Service services, Southern Pediatric Clinic is an excellent option. We are here to help you get the care you need.

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Overview of Southern Pediatric Clinic

  • NPI number: 1558967950
  • Provider type: Organization
  • Active since: 10/08/2015
  • Last updated: 11/03/2015

Primary Scrop of Practice

  • Taxonomy Code: 261QH0100X
  • Specialty: Health Service
  • License Number: MD12866R
  • License State: LA

Provider Mailing Address

  • Address: 202 N Thomas Dr
    Suite 1
    Shreveport, LA 71107
  • Phone: 318-221-0277
  • Fax: 318-221-3277

Provider Practice Location

  • Address: 202 N Thomas Dr
    Suite 1
    Shreveport, LA 71107
  • Phone: 318-221-0277
  • Fax: 318-221-3277

Authorized Official

  • Name: Stella Grace Immanuel MD
  • Position/Title: Owner
  • Telephone Number: 318-221-0277

Scope of Practice

  • Taxonomy Code: 261QH0100X
  • Specialty: Health Service
  • License Number: MD12866R
  • License State: LA
  • Switch: Yes

Legacy Identifiers

  • Provider Identifier: 1449237
  • Identifier Type: Medicare Oscar/Certification
  • Identifier State: LA
  • Issuer:

Question & Answers

  • Q: What is the npi number?
  • A: An NPI is a 10-digit numeric identifier. It does not carry information about you, such as the State where you practice, your provider type, or your specialization. Your NPI will not change, even if your name, address, taxonomy, or other information changes.
  • Q: What are health care provider taxonomy codes?
  • A: The Health Care Provider (HCP) Taxonomy Codes Codes define a health care service provider type, classification, and area of specialization.
  • Q: What is the npi number for Southern Pediatric Clinic?
  • A: The npi number for Southern Pediatric Clinic is 1104297720.
  • Q: What are Southern Pediatric Clinic's specialties?
  • A: Southern Pediatric Clinic's specialties are Health Service and different specialities.
  • Q: Where is Southern Pediatric Clinic business practice location?
  • A: Southern Pediatric Clinic business practice location is 202 N Thomas Dr, Shreveport, LA 71107.
  • Q: How to contact Southern Pediatric Clinic?
  • A: You can contact Southern Pediatric Clinic via 318-221-0277.
  • Q: What is the authorized official for Southern Pediatric Clinic?
  • A: The authorized office name is Stella Grace Immanuel MD with position/title is Owner and you can reach the authorized official via phone number 3182210277.
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