Individual
DR. DAVID B. SOUTHREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
206 ROUTE 303, VALLEY COTTAGE, NY 10989-2019
(845) 268-0880
(845) 268-0882
Mailing address
155 CRYSTAL RUN RD, MIDDLETOWN, NY 10941-4028
(845) 703-6999
(845) 703-6297
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
163321-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01097649
—
NY
Enumeration date
07/18/2006
Last updated
07/03/2014
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