Organization
HOUSTON COUNTY HEALTHCARE AUTHORITY
Active
Parent organization
HOUSTON COUNTY HEALTHCARE AUTHORITY
Other names
Southeast Alabama Medical Center Medical Clinics
Organization subpart
Yes
Provider details
NPI number
Legal business name
HOUSTON COUNTY HEALTHCARE AUTHORITY
Authorized official
MR. ROBERT DEREK MILLER (CFO)
(334) 793-8087
Entity
Organization
Contact information
Practice address
1108 ROSS CLARK CIR, DOTHAN, AL 36301-3022
(334) 793-8087
(334) 678-2895
Mailing address
PO BOX 1928, DOTHAN, AL 36302-1928
(334) 793-8087
(334) 678-2895
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207T00000X
Neurological Surgery Physician
—
—
2084N0400X
Neurology Physician
—
—
2084P0800X
Psychiatry Physician
—
—
208800000X
Urology Physician
—
—
208VP0000X
Pain Medicine Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
153687
—
AL
05
—
300041577AH
—
GA
Enumeration date
10/15/2013
Last updated
12/02/2015
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