Graduated: 1987
NPI: 1790880144
Practice Locations (2)
SOUTHLAND CONSOLIDATED EMERGENCY SERVICES LLC
88 MARTIN LUTHER KING JR DR
FORSYTH, GA 310291682
4789942521
6501 PEAKE RD
MACON, GA 312108051
4784719500
Source: CMS National Downloadable File, September 2026.