Organization
SOUTHEAST ALABAMA MATERNITY CARE PROGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARY BENNETT (DIRECTOR)
(334) 712-3784
Entity
Organization
Contact information
Practice address
545 W MAIN ST STE 3, DOTHAN, AL 36301-1653
(334) 712-3784
(334) 712-3249
Mailing address
PO BOX 6987, DOTHAN, AL 36302-6987
(334) 712-3784
(334) 712-3249
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
—
—
Other
Enumeration date
10/26/2006
Last updated
08/22/2020
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