Provider Demographics
NPI:1144764796
Name:PSYCHIATRY SOUTH, INC.
Entity Type:Organization
Organization Name:PSYCHIATRY SOUTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:HAMILTON
Authorized Official - Last Name:LAZENBY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-987-0724
Mailing Address - Street 1:3000 SOUTHLAKE PARK
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35244-3293
Mailing Address - Country:US
Mailing Address - Phone:205-987-0724
Mailing Address - Fax:205-987-0725
Practice Address - Street 1:3000 SOUTHLAKE PARK
Practice Address - Street 2:SUITE 100
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35244-3293
Practice Address - Country:US
Practice Address - Phone:205-987-0724
Practice Address - Fax:205-987-0725
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-15
Last Update Date:2016-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-131966363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty