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Organization
SOUTHEASTERN INTEGRATED MEDICAL PL
Active
Organization
SOUTHEASTERN INTEGRATED MEDICAL PL
Active
Parent organization
SOUTHEASTERN INTEGRATED MEDICAL PL
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTHEASTERN INTEGRATED MEDICAL PL
Authorized official
DANIEL M DUNCANSON M.D.,C.P.E. (CHEIF EXECUTIVE OFFICER)
(352) 224-2200
Entity
Organization
Contact information
Practice address
4343 W NEWBERRY RD, GAINESVILLE, FL 32607-2817
(352) 224-2200
(352) 224-2484
Mailing address
4881 NW 8TH AVE, SUITE 2, GAINESVILLE, FL 32605-4582
(352) 547-2373
(352) 416-1813
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
—
NULL
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
—
—
207KA0200X
Allergy Physician
—
NULL
207KA0200X
Allergy Physician
—
—
207KI0005X
Clinical & Laboratory Immunology (Allergy & Immunology) Physician
—
NULL
207KI0005X
Clinical & Laboratory Immunology (Allergy & Immunology) Physician
—
—
207NS0135X
Procedural Dermatology Physician
—
NULL
207NS0135X
Procedural Dermatology Physician
—
—
207Q00000X
Family Medicine Physician
—
NULL
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
207RC0001X
Clinical Cardiac Electrophysiology Physician
—
NULL
207RC0001X
Clinical Cardiac Electrophysiology Physician
—
—
207RM1200X
Magnetic Resonance Imaging (MRI) Internal Medicine Physician
—
NULL
207RM1200X
Magnetic Resonance Imaging (MRI) Internal Medicine Physician
—
—
207RR0500X
Rheumatology Physician
—
NULL
207RR0500X
Rheumatology Physician
—
—
207T00000X
Neurological Surgery Physician
—
NULL
207T00000X
Neurological Surgery Physician
—
—
207U00000X
Nuclear Medicine Physician
—
NULL
207U00000X
Nuclear Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
NULL
207V00000X
Obstetrics & Gynecology Physician
—
—
207VG0400X
Gynecology Physician
—
NULL
207VG0400X
Gynecology Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
NULL
207X00000X
Orthopaedic Surgery Physician
—
—
207YS0123X
Facial Plastic Surgery Physician
—
NULL
207YS0123X
Facial Plastic Surgery Physician
—
—
Other
Enumeration date
01/17/2006
Last updated
03/09/2015
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