Organization
SOUTHEAST FAMILY HEALTHCARE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERESA C LASSITER (OFFICE MANAGER)
(334) 983-5994
Entity
Organization
Contact information
Practice address
15079 S US HIGHWAY 231, MIDLAND CITY, AL 36350-6305
(334) 983-5994
(334) 983-4954
Mailing address
15079 S US HIGHWAY 231, MIDLAND CITY, AL 36350-6305
(334) 983-5994
(334) 983-4954
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
22263
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009996800
—
AL
Enumeration date
09/22/2006
Last updated
04/30/2013
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