Organization
SOUTHERN CLINIC PC
Active
Organization
SOUTHERN CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN HOLMAN (OFFICE ADMINISTRATOR)
(334) 794-6611
Entity
Organization
Contact information
Practice address
1901 MELBA DR, DOTHAN, AL 36301-3017
(334) 794-6611
(334) 794-6614
Mailing address
1901 MELBA DR, DOTHAN, AL 36301-3017
(334) 794-6611
(334) 794-6614
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Q684
BC/BS OF ALABAMA
AL
Enumeration date
09/22/2006
Last updated
02/01/2008
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up