MEDICARE: SOUTHLAKE PEDIATRICS, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	16701	AL

General Provider Information

NPI Number	:	1144315250
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTHLAKE PEDIATRICS, INC.

Provider Business Mailing Address
First Line	:	4515 SOUTHLAKE PARKWAY
Second Line	:	SUITE 202
City	:	BIRMINGHAM
State	:	LA
Zip	:	35244-3317
Country	:	US
Telephone Number	:	205-982-2500
Fax Number	:	205-982-2574

Provider Business Practice Location Address
First Line	:	4515 SOUTHLAKE PARKWAY
Second Line	:	SUITE 202
City	:	BIRMINGHAM
State	:	LA
Zip	:	35244-3317
Country	:	US
Telephone Number	:	205-982-2500
Fax Number	:	205-982-2574

Authorized Official
Title or Position	:	PHYSICIAN/DIRECTOR
Name	:	DR. ANDREW N MCCOWN
Credential	:	M.D.
Telephone Number	:	205-982-2500

Provider Enumeration Date	:	10/04/2006
Last Update Date	:	08/29/2007

Similar Medicare Providers

1407822265 — LISA A KENNEDY O.D.
Practice Location Address:

4515 SOUTHLAKE PKWY
BIRMINGHAM, AL
35244-3317

Practice Phone: 205-987-2020
Practice Fax: 205-988-0588

1518981034 — DR. LARRY GENE DEEP DMD
Practice Location Address:

4515 SOUTHLAKE PKWY , SUITE 101
BIRMINGHAM, AL
35244-3317

Practice Phone: 205-988-5656
Practice Fax: 205-988-3972

1730103136 — DR. EMILY INGRAM PAYNE D.M.D.
Practice Location Address:

4515 SOUTHLAKE PKWY , SUITE 101
BIRMINGHAM, AL
35244-3317

Practice Phone: 205-988-5656
Practice Fax: 205-988-3972

1134137755 — CHARLES STEVEN DAUGHTRY D. M. D.
Practice Location Address:

4515 SOUTHLAKE PKWY , STE 101
BIRMINGHAM, AL
35244-3317

Practice Phone: 205-988-5656
Practice Fax:

1841301959 — DR. KELLY ELISE HILL D.M.D
Practice Location Address:

4515 SOUTHLAKE PKWY , SUITE 200
BIRMINGHAM, AL
35244-3317

Practice Phone: 205-453-0314
Practice Fax:

1518078674 — MEDPLEX PEDIATRIC DENTISTRY, INC.
Practice Location Address:

4515 SOUTHLAKE PKWY , SUITE 200
BIRMINGHAM, AL
35244-3317

Practice Phone: 205-453-0314
Practice Fax: 205-453-0315

Directions to “SOUTHLAKE PEDIATRICS, INC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.