Organization
SOUTHCOAST MEDICAL SERVICES
Active
Other names
The Perdido Bay Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE HAWTHORNE MS (CREDENTIALING AND BILLING MANAGER)
(205) 292-2428
Entity
Organization
Contact information
Practice address
34463 US HIGHWAY 98 STE G, LILLIAN, AL 36549-4049
(251) 961-0874
Mailing address
7094 FOREST MILL DR, COTTONDALE, AL 35453-1446
(205) 292-2428
(205) 462-3703
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
10/19/2020
Last updated
10/30/2020
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