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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