Organization
SOUTHEASTERN SPINE SPECIALISTS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY DAVID BASSETT MD (PRESIDENT)
(205) 750-0447
Entity
Organization
Contact information
Practice address
1781 COMMONS NORTH LOOP, TUSCALOOSA, AL 35406-3577
(205) 750-0447
(205) 750-0276
Mailing address
1781 COMMONS NORTH LOOP, TUSCALOOSA, AL 35406-3577
(205) 750-0447
(205) 750-0276
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
00018074
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
051527770
—
AL
01
—
51527770
BC/BS
SC
Enumeration date
12/05/2005
Last updated
07/27/2009
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