Organization
SOUTHEAST PHYSICIAN NETWORK, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHELBY SANFORD MD (PRESIDENT)
(205) 345-8208
Entity
Organization
Contact information
Practice address
1410 MCFARLAND BLVD N, TUSCALOOSA, AL 35406-2209
(205) 345-8208
(205) 345-8209
Mailing address
1400 AFFLINK PL STE 101, TUSCALOOSA, AL 35406-2452
(205) 345-8208
(205) 345-8209
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
10900
AL
2085R0001X
Radiation Oncology Physician
10900
AL
208800000X
Urology Physician
10900
AL
Other
Enumeration date
10/05/2009
Last updated
09/10/2019
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