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Organization
SOUTHEASTERN PATHOLOGY ASSOCIATES PC
Active
Organization
SOUTHEASTERN PATHOLOGY ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PATRICK E GODBEY M.D. (PRESIDENT)
(912) 261-2669
Entity
Organization
Contact information
Practice address
203 INDIGO DR, BRUNSWICK, GA 31525-6865
(912) 261-2669
(912) 261-0753
Mailing address
203 INDIGO DR, BRUNSWICK, GA 31525-6865
(912) 261-2669
(912) 261-0561
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
291U00000X
Clinical Medical Laboratory
063012
GA
291U00000X
Clinical Medical Laboratory
800015943
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
030703300
—
FL
05
—
030707600
—
FL
05
—
031806000
—
FL
01
—
04485
BSGA GROUP
GA
05
—
197742702A
—
GA
05
—
197742702B
—
GA
01
—
38374
BSFL GROUP
FL
Enumeration date
08/22/2006
Last updated
10/26/2021
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