Organization
SOUTHEAST PEDIATRICS,P.C.
Active
Organization
SOUTHEAST PEDIATRICS,P.C.
Active
Parent organization
SOUTHEAST PEDIATRICS,P.C
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTHEAST PEDIATRICS,P.C
Authorized official
DR. MOLLIE ANN WALKER M.D. (OWNER)
(334) 724-0550
Entity
Organization
Contact information
Practice address
804 CRAWFORD ST, TUSKEGEE, AL 36083-7262
(334) 724-0550
(334) 724-0591
Mailing address
804 CRAWFORD ST, TUSKEGEE, AL 36083-7262
(334) 724-0550
(334) 724-0591
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
11822
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
529933919
—
AL
Enumeration date
09/27/2012
Last updated
09/27/2012
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