SOUTHEASTERN CLINICAL LABORATORIES PA (NPI# 1548224256) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548224256 |
| Entity Type | Organization |
| Organization Name | SOUTHEASTERN CLINICAL LABORATORIES PA |
| Practice Address |
2003 Falls Rd Toccoa GA 30577-9700 |
| Mailing Address |
Po Box 52990 Greenwood SC 29649-0048 |
| Practice Telephone | 7062824245 |
| Mailing Telephone | 8642233600 |
| Mailing Fax Number | 8642236054 |
| Enumeration Date | 2006-04-12 |
| Last Update Date | 2008-04-17 |
| Authorized Official Name | DR. JAMES ROBERT PRUITT (PRESIDENT) |
| Authorized Official Telephone | 7062824245 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
4472 | SC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | PA6065 | 05 |
| Street Address |
2003 FALLS RD |
| City | TOCCOA |
| State | GA |
| Zip Code | 30577-9700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144203290 | Dennis Dukes | Emergency Medicine | 2003 Falls Rd, Toccoa, GA 30577-9700 | 2005-11-22 |
| 1578758330 | Stephens County Hospital Pharmacy | Pharmacy | 2003 Falls Rd, Toccoa, GA 30577-9700 | 2007-09-13 |
| 1891903225 | Linda Mary Scott | Nurse Practitioner | 2003 Falls Rd, Toccoa, GA 30577-9700 | 2007-05-18 |
| 1205054954 | Stephens County Pathology Associates LLC | Pathology | 2003 Falls Rd, Toccoa, GA 30577-9700 | 2007-04-20 |
| 1376683136 | Stephanie Jeanne Ruccio | Physical Therapist | 2003 Falls Rd, Toccoa, GA 30577-9700 | 2007-02-08 |
| 1346380193 | Angela Renae King | Physical Therapist | 2003 Falls Rd, Toccoa, GA 30577-9700 | 2007-02-08 |
| 1801936521 | Autumn Renee Hillegas | Occupational Therapist | 2003 Falls Rd, Toccoa, GA 30577-9700 | 2007-02-08 |
| 1770623530 | Stephen Garst | Physical Therapist | 2003 Falls Rd, Toccoa, GA 30577-9700 | 2007-02-08 |
| 1356499461 | Steven Andrew Nichols | Pharmacist | 2003 Falls Rd, Toccoa, GA 30577-9700 | 2007-01-08 |
| 1215991450 | Susan Thrasher Martin | Pathology | 2003 Falls Rd, Toccoa, GA 30577-9700 | 2006-04-14 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982220513 | Jennifer Lynn Harper | Counselor | 46 Rice Lewis Gilliard Way, Toccoa, GA 30577 | 2020-06-19 |
| 1912528696 | Pittard Clinic LLC | Clinic/Center | 1654 Falls Rd, Toccoa, GA 30577 | 2020-05-04 |
| 1518313733 | Shellei Adams | Occupational Therapist | 23 Big A Rd, Toccoa, GA 30577 | 2016-05-06 |
| 1902212814 | Rebecca Coursey | Counselor | 1763 Fernside Dr., Avita Community Partners, Toccoa, GA 30577 | 2014-07-11 |
| 1427478742 | Cynthia Hemphill Wansley | Pharmacist | 3886 Georgia Highway 17, Toccoa, GA 30577 | 2014-04-25 |
| 1265850168 | Karen Kelley Colwell | Pharmacist | 3886 Hwy 17, Toccoa, GA 30577 | 2014-03-29 |
| 1972808160 | Cossar Chiropractic | Chiropractor | 2766 Ga Hwy 17, Toccoa, GA 30577 | 2011-01-19 |
| 1811216070 | Georgia Mountains Community Services | Day Training, Developmentally Disabled Services | 130 Haynes St, Toccoa, GA 30577 | 2010-05-26 |
| 1942435516 | Meadows Surgical Arts | Specialist | 203 Remsdale Rd, Toccoa, GA 30577 | 2009-05-26 |
| 1609011816 | Bryan Gerald Wood | Pharmacist | 102 N Sage Street, Stewart's Downtown Discount Drugs, Toccoa, GA 30577 | 2008-12-03 |
| Find all providers in zip 30577 | ||||
| Taxonomy Code | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205054954 | Stephens County Pathology Associates LLC | Pathology | 2003 Falls Rd, Toccoa, GA 30577-9700 | 2007-04-20 |
| 1215991450 | Susan Thrasher Martin | Pathology | 2003 Falls Rd, Toccoa, GA 30577-9700 | 2006-04-14 |
| 1891759585 | Edward Michael Mckee | Pathology | 2003 Falls Rd, Toccoa, GA 30577-9700 | 2006-04-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255957148 | Thomas E Cotter | Pathology | 1120 15th St # Bf-103b, Augusta, GA 30912-0004 | 2020-06-17 |
| 1386269835 | Pramila Pallikkappara Moideen | Pathology | Augusta University Medical Center Room Bf-103-b, Augusta, GA 30912-0001 | 2020-06-10 |
| 1558921973 | Anna Nielsen Walker | Pathology | Mercer University School of Medicine Dept of Pathology, Macon, GA 31207-0001 | 2019-06-18 |
| 1437678950 | Thomas William Stewart Jr. | Pathology | 3138 Marthasville Court, Gainesville, GA 30506 | 2017-09-15 |
| 1700225760 | Robert John Nelms Jr. | Pathology | 107 Fairway Dr, Moultrie, GA 31768-6823 | 2013-06-22 |
| 1750725099 | Charles Jacob Stoudenmire | Pathology | 507 W 3rd Ave Ste 7, Albany, GA 31701 | 2013-04-17 |
| 1902143589 | Lindsey Oreita Lowder | Pathology | 1968 Peachtree Rd Nw Bldg 774th, Atlanta, GA 30309-1281 | 2013-01-15 |
| 1184918476 | Stephen Alan Dayan | Pathology | 830 Johns Landing Way, Lawrenceville, GA 30045-6369 | 2011-06-03 |
| 1760793673 | Andrew Erling Johnsen | Pathology | 3248 Avalon Pkwy, Conyers, GA 30013-6320 | 2010-06-24 |
| 1497066518 | Charles Omar Wilson Jr. | Pathology | 175 Samaritan Way, Jasper, GA 30143 | 2010-06-23 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.