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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