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Organization
SOUTHCOAST MEDICAL SERVICES
Active
Organization
SOUTHCOAST MEDICAL SERVICES
Active
Other names
The Perdido Bay Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE HAWTHORNE MS (CREDENTIALING AND BILLING MANAGER)
(205) 292-2428
Entity
Organization
Contact information
Practice address
34463 US HIGHWAY 98 STE G, LILLIAN, AL 36549-4049
(251) 961-0874
Mailing address
7094 FOREST MILL DR, COTTONDALE, AL 35453-1446
(205) 292-2428
(205) 462-3703
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
10/19/2020
Last updated
10/30/2020
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