Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Southlake Psychiatry PC

Organization Psychiatry Physician · NPI 1295921724

Southlake Psychiatry PC is a Psychiatry Physician in Davidson, North Carolina. Licensed in North Carolina. Registered with an NPI since 2007.

Licensed in
NC
In the registry since
2007
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

903 NE Dr Ste 301
Davidson, NC 28036
Phone: (704) 894-9309
Fax: (704) 894-9304
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatry Physician (primary) Taxonomy 2084P0800X · Licence 9300112 (NC)

Record details

NPI number1295921724
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Thomas Fitzgerald — President · (704) 894-9309
NPI enumeratedSeptember 18, 2007
Last updated in NPPESAugust 1, 2025
Certification dateAugust 1, 2025
Mailing address903 Northeast Dr, Suite 301, Davidson, NC 28036-7416

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