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Organization

SOUTHEAST PHYSICIAN NETWORK, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
STEVE L MITCHELL (CFO)
(205) 366-1605
Entity
Organization

Contact information

Practice address
1400 AFFLINK PL, SUITE 100, TUSCALOOSA, AL 35406-2289
(205) 366-9740
(205) 344-9992
Mailing address
1400 AFFLINK PL, SUITE 100, TUSCALOOSA, AL 35406-2289
(205) 366-9740
(205) 344-9992

Taxonomy

Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
2085R0001X
Radiation Oncology Physician
208800000X
Urology Physician

Other

Enumeration date
07/02/2009
Last updated
02/15/2013
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