| Southland Health Services, Llc | |
|
2036 Chilhowee Medical Park Maryville TN 37804-5285 | |
| (865) 406-2715 | |
| Not Available |
| Full Name | Southland Health Services, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 2036 Chilhowee Medical Park, Maryville, Tennessee |
| Authorized Official Name and Position | Clay Stalcup (CO-OWNER) |
| Authorized Official Contact | 8654062715 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southland Health Services, Llc 3834 Jackson Bend Dr Louisville TN 37777-3791 Ph: () - | Southland Health Services, Llc 2036 Chilhowee Medical Park Maryville TN 37804-5285 Ph: (865) 406-2715 |
| NPI Number | 1518650001 |
|---|---|
| Provider Enumeration Date | 05/31/2023 |
| Last Update Date | 05/31/2023 |
| Certification Date | 05/31/2023 |
| Medicare PECOS PAC ID | 3577903137 |
|---|---|
| Medicare Enrollment ID | O20240430000672 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518650001 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Secondary |
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Clay E Stalcup |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750389979 PECOS PAC ID: 8820041023 Enrollment ID: I20050228001012 |
| Provider Name | Sadonya Meadows Meadows Allen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740586726 PECOS PAC ID: 4587954946 Enrollment ID: I20160526001483 |
| Provider Name | Kati Kerr Carley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427612027 PECOS PAC ID: 8325458573 Enrollment ID: I20201029001873 |
| Provider Name | Melissa Marie Horn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871273011 PECOS PAC ID: 2365894581 Enrollment ID: I20240123003059 |
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