Healthcare Provider Details

I. General information

NPI: 1124092481
Provider Name (Legal Business Name): SPRINGHILL MEDICAL SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2006
Last Update Date: 05/19/2021
Certification Date: 05/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 DOCTORS DR
SPRINGHILL LA
71075-4526
US

IV. Provider business mailing address

2001 DOCTORS DR
SPRINGHILL LA
71075-4526
US

V. Phone/Fax

Practice location:
  • Phone: 318-539-1000
  • Fax: 318-539-4085
Mailing address:
  • Phone: 318-539-1000
  • Fax: 318-539-4085

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number441
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL G PATRONIS
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 318-539-1001