| NPI | 1619203791 |
|---|---|
| Doing Business As | SOUTH LAKE PEDIATRICS |
| Entity Type | Organization |
| Authorized Contact | THOMAS LAYMON Senior Vice President 704-446-8250 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics |
| Enumeration Date | 2009-10-26 |
| Last Update Date | 2020-07-16 |