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Organization

SOUTHEAST IMAGING PARTNERS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. RICK L STUKES (MANAGING PARTNER)
(205) 221-3352
Entity
Organization

Contact information

Practice address
1405 VALLEY RD, JASPER, AL 35501-4932
(205) 221-3352
(205) 221-3352
Mailing address
PO BOX 402, JASPER, AL 35502
(205) 221-3352
(205) 221-3352

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
11954
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0515555049
AL
Enumeration date
10/26/2006
Last updated
07/12/2007
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