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Southern Pediatric Clinic, LLC

Pediatrics Physician in Valdosta, GA · enumerated 2008 · authorized official Charlene Blache, Owner/Physician.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1982858767

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Registry record

Entity type Organization (Type 2)
Legal business name Southern Pediatric Clinic, LLC
Practice address 406 M Northside Drive, Valdosta, GA, 31602
Phone (229) 241-0059
Fax (229) 241-0059
Enumeration date Nov 6, 2008
Last updated in NPPES Feb 3, 2017

Taxonomy & classification

208000000X Pediatrics Physician Allopathic & Osteopathic Physicians Primary

Authorized official

Name Charlene Blache
Title Owner/Physician
Phone (229) 241-0059

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

How current is this record?
Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2017-02-03. Verify at npiregistry.cms.hhs.gov.
Where is Southern Pediatric Clinic, LLC located?
The practice location on file with NPPES is in Valdosta, GA.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2017-02-03.