Southlake Psychiatry Pc in Davidson - Psychiatry
Southlake Psychiatry Pc - NPI 1295921724
Southlake Psychiatry Pc is a Psychiatry in Davidson, North Carolina. Southlake Psychiatry Pc practices all healthcare services and medical treatments related to Psychiatry. The NPI Number for Southlake Psychiatry Pc is 1295921724. The last update date is 2015-06-30.
Southlake Psychiatry Pc's current location address is 903 Northeast Dr, Davidson, North Carolina. You can contact this provider via phone number 7048949309 and fax number 7048949304. The mailing address for Southlake Psychiatry Pc is 903 Northeast Dr, Davidson, North Carolina. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Southlake Psychiatry Pc |
|---|---|
| Address | 903 Northeast Dr, Davidson, North Carolina |
| Phone Number | 7048949309 |
| Fax Number | 7048949304 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PRESIDENT |
|---|---|
| Authorized Official Name | Fitzgerald Michael Thomas |
| Credentials | MD |
| Telephone Number | 7048949309 |
NPI Number Detail
| NPI Number | 1295921724 |
|---|---|
| Provider Enumeration Date | 2007-09-18 |
| Last Updated Date | 2015-06-30 |
Provider Mailing Address Detail
| Address | 903 Northeast Dr |
|---|---|
| City | Davidson |
| State | North Carolina (NC) |
| Post Code | 280367416 |
| Phone Number | 7048949309 |
| Fax Number | 7048949304 |
Provider's Primary Taxonomy Detail
| Speciality | Psychiatry |
|---|---|
| Taxonomy | 2084P0800X |
| Licence No | 9300112 |
|
Definition: A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| B3348 | NC | BCBS | |
| 8932269 | NC | -- |
Post Comment/ Review Below
What is the unique 10-digit identifier code issued to Southlake Psychiatry Pc by the Centers for Medicare & Medicaid Services?
The Southlake Psychiatry Pc has been assigned the NPI (National Provider Identifier) 1295921724 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you please provide the complete street address where Southlake Psychiatry Pc is physically located?
The Southlake Psychiatry Pc is physically situated at the following address: 903 Northeast Dr, Davidson, NC, 280367416.
What is Southlake Psychiatry Pc's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Southlake Psychiatry Pc's specialized field of practice is Psychiatry, and the corresponding taxonomy code that categorizes this area of specialization is 2084P0800X.
On what date did the Centers for Medicare & Medicaid Services issue the 1295921724 to Southlake Psychiatry Pc?
The Southlake Psychiatry Pc received its 1295921724 assignment from the Centers for Medicare & Medicaid Services on 2007-09-18.
When was the information related to Southlake Psychiatry Pc most recently updated or refreshed?
The details pertaining to the Southlake Psychiatry Pc, including its address, specialty, and other relevant information, were last updated or refreshed on 2015-06-30.
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