Organization
SOUTHEAST ALABAMA ENT HEAD & NECK
Active
Other names
Alabama ENT Head & Neck
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NANCY P WINDHAM (OFFICE ADMINISTRATOR)
(334) 702-6900
Entity
Organization
Contact information
Practice address
1118 ROSE CLARK CIRCLE, STE 210, DOTHAN, AL 36301
(334) 702-6900
(334) 677-7749
Mailing address
1118 ROSE CLARK CIRCLE, STE 210, DOTHAN, AL 36301
(334) 702-6900
(334) 677-7749
Taxonomy
Speciality
Code
Description
License number
State
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
00025142
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51515841
BLUE CROSS
—
Enumeration date
08/02/2006
Last updated
08/22/2020
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