# SOUTHEASTERN CLINICAL INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730204736
- **Authorized official:** DR. RICKY LYNN JUDGE MD (PRESIDENT)
- **Authorized official phone:** (405) 947-8584

## Contact information

- **Practice address:** 1 E CLARK BASS BLVD, MCALESTER, OK 74501-4209
- **Practice address phone:** (405) 947-8584
- **Practice address fax:** (405) 948-6507
- **Mailing address:** 1 E CLARK BASS BLVD, MCALESTER, OK 74501-4209
- **Mailing address phone:** (405) 947-8584
- **Mailing address fax:** (405) 948-6507

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | 17491 | OK | Yes |

## Other

- **Enumeration date:** 03/20/2007
- **Last updated:** 08/22/2020