Organization
SOUTHEASTERN PAIN MANAGEMENT LLC
Active
Other names
Coastal States Management
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY JACOBS-MURATTA (CHIEF OPERATING OFFICER)
(256) 492-7246
Entity
Organization
Contact information
Practice address
1026 GOODYEAR AVE, BLDG 400 STE 302, GADSDEN, AL 35903-1102
(256) 492-7246
(256) 492-1168
Mailing address
1026 GOODYEAR AVE, BLDG 400 STE 302, GADSDEN, AL 35903-1102
(256) 492-7246
(256) 492-1168
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51521436
BLUE CROSS BLUE SHIELD
AL
01
—
D97686
HEALTHSPRINGS OF ALABAMA
AL
01
—
P00145166
RAILROAD MEDICARE
AL
Enumeration date
12/01/2006
Last updated
07/14/2008
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