Organization
SOUTHEASTERN CLINICAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICKY L JUDGE MD (MEDICAL DIRECTOR)
(918) 423-6791
Entity
Organization
Contact information
Practice address
716 E WYANDOTTE AVE, MCALESTER, OK 74501-5428
(918) 423-6791
(405) 948-6507
Mailing address
PO BOX 21568, DEPT 148, TULSA, OK 74121-1568
(405) 947-8584
(405) 948-6507
Taxonomy
Speciality
Code
Description
License number
State
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
—
—
Other
Enumeration date
04/12/2007
Last updated
04/20/2008
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