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Organization
SOUTHEASTERN PHYSICIAN SERVICES PC
Active
Organization
SOUTHEASTERN PHYSICIAN SERVICES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDAL L DABBS MD (PRESIDENT)
(888) 203-1274
Entity
Organization
Contact information
Practice address
990 OAK RIDGE TPKE, OAK RIDGE, TN 37830-6976
(865) 481-1000
Mailing address
PO BOX 635705, CINCINNATI, OH 45263-5705
(888) 203-1274
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
TN
207X00000X
Orthopaedic Surgery Physician
—
NULL
207X00000X
Orthopaedic Surgery Physician
—
—
208M00000X
Hospitalist Physician
Primary
—
TN
261QM0850X
Adult Mental Health Clinic/Center
—
NULL
363A00000X
Physician Assistant
—
TN
363AM0700X
Medical Physician Assistant
—
NULL
363AM0700X
Medical Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
TN
Other
Enumeration date
05/02/2007
Last updated
01/31/2020
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