Organization
HOUSTON COUNTY HEALTHCARE AUTHORITY
Active
Parent organization
HOUSTON COUNTY HEALTHCARE AUTHORITY
Other names
Southeast Surgical Associates
Organization subpart
Yes
Provider details
NPI number
Legal business name
HOUSTON COUNTY HEALTHCARE AUTHORITY
Authorized official
ROBERT DEREK MILLER (CFO)
(334) 793-8111
Entity
Organization
Contact information
Practice address
1812 E MAIN ST, DOTHAN, AL 36301-3000
(334) 792-5184
(334) 792-5190
Mailing address
PO BOX 1928, DOTHAN, AL 36302-1928
(334) 792-5184
(334) 792-5190
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
153687
—
AL
Enumeration date
04/05/2016
Last updated
04/05/2016
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