Provider Demographics
NPI:1154628683
Name:SOUTHERN SLEEP CLINICS LLC
Entity Type:Organization
Organization Name:SOUTHERN SLEEP CLINICS LLC
Other - Org Name:COVINGTON NEUROLOGY & SLEEP CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:LABANOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:334-673-2501
Mailing Address - Street 1:2346 W MAIN ST STE 3
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36301-1276
Mailing Address - Country:US
Mailing Address - Phone:334-673-2501
Mailing Address - Fax:334-673-2502
Practice Address - Street 1:512 E THREE NOTCH ST
Practice Address - Street 2:
Practice Address - City:ANDALUSIA
Practice Address - State:AL
Practice Address - Zip Code:36420-3128
Practice Address - Country:US
Practice Address - Phone:334-222-3700
Practice Address - Fax:334-222-3720
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-18
Last Update Date:2011-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL277422084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALPENDINGMedicare PIN