Provider Demographics
NPI:1033379813
Name:SOUTHLAND MEDICAL SOLUTIONS OF AL PL
Entity Type:Organization
Organization Name:SOUTHLAND MEDICAL SOLUTIONS OF AL PL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:DUANE
Authorized Official - Last Name:HART
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:850-499-0825
Mailing Address - Street 1:7004 NW 52ND TER
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32653-7008
Mailing Address - Country:US
Mailing Address - Phone:205-907-2586
Mailing Address - Fax:205-678-2700
Practice Address - Street 1:7004 NW 52ND TER
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32653-7008
Practice Address - Country:US
Practice Address - Phone:205-907-2586
Practice Address - Fax:205-678-2700
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOUTHLAND MEDICAL SOLUTIONS OF FL PL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-06-14
Last Update Date:2008-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty