Southlake Clinic Inc., P.S. in Renton - Infectious Disease
Southlake Clinic Inc., P.S. - NPI 1104962331
Southlake Clinic Inc., P.S. is a Infectious Disease in Renton, Washington. Southlake Clinic Inc., P.S. practices all healthcare services and medical treatments related to Infectious Disease. The NPI Number for Southlake Clinic Inc., P.S. is 1104962331. The last update date is 2017-07-13.
Southlake Clinic Inc., P.S.'s current location address is Po Box 59028, Renton, Washington. You can contact this provider via phone number 4252515110 and fax number 4252771301. The mailing address for Southlake Clinic Inc., P.S. is Po Box 59028, Renton, Washington. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Southlake Clinic Inc., P.S. |
|---|---|
| Address | Po Box 59028, Renton, Washington |
| Phone Number | 4252515110 |
| Fax Number | 4252771301 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | COO |
|---|---|
| Authorized Official Name | Hudson Dwight James |
| Credentials | MHA |
| Telephone Number | 4257934725 |
NPI Number Detail
| NPI Number | 1104962331 |
|---|---|
| Provider Enumeration Date | 2007-01-29 |
| Last Updated Date | 2017-07-13 |
Provider Mailing Address Detail
| Address | Po Box 59028 |
|---|---|
| City | Renton |
| State | Washington (WA) |
| Post Code | 980582028 |
| Phone Number | 4252515110 |
| Fax Number | 4252771301 |
Provider's Primary Taxonomy Detail
| Speciality | Infectious Disease |
|---|---|
| Taxonomy | 207Ri0200X |
|
Definition: An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers whi |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 7072440 | WA | -- | |
| CS3809 | WA | RR MEDICARE | |
| 57600 | WA | L&I |
Post Comment/ Review Below
What is the unique identification code assigned to Southlake Clinic Inc., P.S. by the Centers for Medicare & Medicaid Services?
The Southlake Clinic Inc., P.S. has been issued the NPI (National Provider Identifier) 1104962331. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete physical location address of Southlake Clinic Inc., P.S.?
The Southlake Clinic Inc., P.S. is physically situated at Po Box 59028, in the city of Renton, state of WA, with the postal code 980582028.
What is Southlake Clinic Inc., P.S.'s primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Southlake Clinic Inc., P.S. is Infectious Disease, and the corresponding taxonomy classification code for this specialized field is 207Ri0200X.
On what date did the Centers for Medicare & Medicaid Services issue the 1104962331 to Southlake Clinic Inc., P.S.?
The Southlake Clinic Inc., P.S. received its 1104962331 assignment from the Centers for Medicare & Medicaid Services on 2007-01-29.
As of what date was the information pertaining to Southlake Clinic Inc., P.S., such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Southlake Clinic Inc., P.S., including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2017-07-13.