# SOUTHEASTERN INTEGRATED MEDICAL PL

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** SOUTHEASTERN INTEGRATED MEDICAL PL
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1871573949
- **Legal business name:** SOUTHEASTERN INTEGRATED MEDICAL PL
- **Authorized official:** DANIEL M DUNCANSON M.D.,C.P.E. (CHEIF EXECUTIVE OFFICER)
- **Authorized official phone:** (352) 224-2200

## Contact information

- **Practice address:** 4343 W NEWBERRY RD, GAINESVILLE, FL 32607-2817
- **Practice address phone:** (352) 224-2200
- **Practice address fax:** (352) 224-2484
- **Mailing address:** 4881 NW 8TH AVE, SUITE 2, GAINESVILLE, FL 32605-4582
- **Mailing address phone:** (352) 547-2373
- **Mailing address fax:** (352) 416-1813

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 204D00000X | Neuromusculoskeletal Medicine & OMM Physician | — | NULL | Yes |
| 204D00000X | Neuromusculoskeletal Medicine & OMM Physician | — | — | Yes |
| 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