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Organization

SOUTHEAST CARDIOLOGY CLINIC INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. DONNA BRIDWELL (INSURANCE SUPERVISOR)
(334) 712-1929
Entity
Organization

Contact information

Practice address
1150 ROSS CLARK CIR, DOTHAN, AL 36301-3022
(334) 712-1929
(334) 712-2799
Mailing address
1150 ROSS CLARK CIR, DOTHAN, AL 36301-3022
(334) 712-1929
(334) 712-2799

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
258388700
FL
05
529301110
AL
Enumeration date
12/28/2006
Last updated
08/03/2011
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