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Organization
SOUTHEASTERN INTENSIVIST SERVICES PC
Active
Organization
SOUTHEASTERN INTENSIVIST SERVICES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDAL L DABBS M.D. (PRESIDENT)
(865) 693-1000
Entity
Organization
Contact information
Practice address
2100 N 7TH ST, WEST MEMPHIS, AR 72301-2017
(870) 733-3020
Mailing address
PO BOX 635134, CINCINNATI, OH 45263-5134
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
208M00000X
Hospitalist Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3733831
—
TN
Enumeration date
06/17/2006
Last updated
11/28/2018
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