MEDICARE: SOUTHERN DIAGNOSTIC SERVICES, 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	293D00000X	Physiological Laboratory

General Provider Information

NPI Number	:	1114102019
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTHERN DIAGNOSTIC SERVICES, INC.

Provider Business Mailing Address
First Line	:	425 W 3RD AVE
Second Line	:	SUITE 510
City	:	ALBANY
State	:	GA
Zip	:	31701-1941
Country	:	US
Telephone Number	:	229-312-7519
Fax Number	:	229-312-7505

Provider Business Practice Location Address
First Line	:	425 W 3RD AVE
Second Line	:	SUITE 510
City	:	ALBANY
State	:	GA
Zip	:	31701-1941
Country	:	US
Telephone Number	:	229-312-7519
Fax Number	:	229-312-7505

Authorized Official
Title or Position	:	PRESIDENT / CEO
Name	:	MR. PAUL F. HENDLEY JR.
Credential	:
Telephone Number	:	229-886-5972

Provider Enumeration Date	:	01/09/2008
Last Update Date	:	01/09/2008

Similar Medicare Providers

1376545053 — MARK D COHEN M.D.
Practice Location Address:

425 W 3RD AVE , SUITE 600
ALBANY, GA
31701-1941

Practice Phone: 229-431-1022
Practice Fax: 229-431-2068

1437144904 — STEPHEN C ALLEN M.D.
Practice Location Address:

425 W 3RD AVE , SUITE 550
ALBANY, GA
31701-1941

Practice Phone: 229-432-8463
Practice Fax: 229-432-8465

1265419352 — DR. OTHA BURNETT CARTER JR. M.D.
Practice Location Address:

425 W 3RD AVE , SUITE 400
ALBANY, GA
31701-1941

Practice Phone: 229-883-6311
Practice Fax: 229-883-6315

1194702290 — DR. HARRY DOUGLAS VILDIBILL M.D.
Practice Location Address:

425 W 3RD AVE , SUITE 400
ALBANY, GA
31701-1941

Practice Phone: 229-883-6311
Practice Fax: 229-883-6315

1699747824 — ANTHONY V HOOTS MD
Practice Location Address:

425 W 3RD AVE , STE 525
ALBANY, GA
31701-1941

Practice Phone: 229-312-7510
Practice Fax: 229-312-7505

1932171568 — JOHN T PHILLIPS IV MD
Practice Location Address:

425 W 3RD AVE , STE 340
ALBANY, GA
31701-1941

Practice Phone: 229-312-9150
Practice Fax: 229-312-9155

1164470761 — JOHN CHARLES BENNETT MD
Practice Location Address:

425 W 3RD AVE , SUITE 410
ALBANY, GA
31701-1941

Practice Phone: 229-312-0707
Practice Fax: 229-312-0705

Directions to “SOUTHERN DIAGNOSTIC SERVICES, 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.