Provider Demographics
NPI:1871507616
Name:SPRINGHILL MEDICAL SERVICES, INC.
Entity Type:Organization
Organization Name:SPRINGHILL MEDICAL SERVICES, INC.
Other - Org Name:SMC DOCTORS CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:G
Authorized Official - Last Name:PATRONIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-539-1001
Mailing Address - Street 1:401 11TH ST NE
Mailing Address - Street 2:
Mailing Address - City:SPRINGHILL
Mailing Address - State:LA
Mailing Address - Zip Code:71075-4503
Mailing Address - Country:US
Mailing Address - Phone:318-539-1700
Mailing Address - Fax:318-539-5688
Practice Address - Street 1:401 11TH ST NE
Practice Address - Street 2:
Practice Address - City:SPRINGHILL
Practice Address - State:LA
Practice Address - Zip Code:71075-4503
Practice Address - Country:US
Practice Address - Phone:318-539-1700
Practice Address - Fax:318-539-5688
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SPRINGHILL MEDICAL SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-28
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA105261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR160435729Medicaid
LA1448290Medicaid
LA1441601Medicaid
193466Medicare Oscar/Certification
AR160435729Medicaid