Organization
SOUTHEASTERN PEDIATRIC ASSOCIATES, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. S. LUCY EVERETT (OFFICE MANAGER)
(334) 794-8656
Entity
Organization
Contact information
Practice address
364 HONEYSUCKLE RD, DOTHAN, AL 36305-1140
(334) 794-8656
(337) 702-7047
Mailing address
364 HONEYSUCKLE RD, DOTHAN, AL 36305-1140
(334) 794-8656
(337) 702-7047
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
272658100
—
FL
05
—
528300110
—
AL
Enumeration date
08/10/2007
Last updated
01/12/2011
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