# SOUTHCOAST MEDICAL SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Other names:** The Perdido Bay Medical Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1497354617
- **Authorized official:** MICHELLE HAWTHORNE MS (CREDENTIALING AND BILLING MANAGER)
- **Authorized official phone:** (205) 292-2428

## Contact information

- **Practice address:** 34463 US HIGHWAY 98 STE G, LILLIAN, AL 36549-4049
- **Practice address phone:** (251) 961-0874
- **Mailing address:** 7094 FOREST MILL DR, COTTONDALE, AL 35453-1446
- **Mailing address phone:** (205) 292-2428
- **Mailing address fax:** (205) 462-3703

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/19/2020
- **Last updated:** 10/30/2020