Organization
SOUTHERN MEDICAL GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CLARICE D KENNEDY (PROVIDER ENROLLMENT SPECIALIST)
(205) 995-7980
Entity
Organization
Contact information
Practice address
1200 CORPORATE DR, SUITE 230, BIRMINGHAM, AL 35242-2941
(205) 995-7980
(205) 995-7985
Mailing address
1200 CORPORATE DR, SUITE 230, BIRMINGHAM, AL 35242-2941
(205) 995-7980
(205) 995-7985
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
152834
AL
Other
Enumeration date
08/10/2006
Last updated
04/20/2008
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