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

Southland Sports Medicine and Wellness, Inc

Organization Family Medicine Physician · NPI 1487671475

Southland Sports Medicine and Wellness, Inc is a Family Medicine Physician in Blue Ridge, Georgia. Licensed in Georgia. Registered with an NPI since 2006.

Licensed in
GA
In the registry since
2006
Specialties on file
2
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

809 E Main St
Blue Ridge, GA 30513-4575
Phone: (706) 632-2200
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Sports Medicine (Physical Medicine & Rehabilitation) Physician (primary) Taxonomy 2081S0010X
Family Medicine Physician Taxonomy 207Q00000X · Licence 33624 (GA)

Record details

NPI number1487671475
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mark Leski — Owner/ Physician · (706) 632-2200
NPI enumeratedJuly 16, 2006
Last updated in NPPESSeptember 11, 2025
Mailing address809 E Main St, Blue Ridge, GA 30513-4575

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