Southeast Medical Group Llc | |
1930 Edwards Lake Rd Ste 138b Birmingham AL 35235-3720 | |
(205) 308-3183 | |
(205) 278-6939 |
Full Name | Southeast Medical Group Llc |
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Speciality | General Practice |
Location | 1930 Edwards Lake Rd Ste 138b, Birmingham, Alabama |
Authorized Official Name and Position | Doug Randall (MANAGING MEMBER) |
Authorized Official Contact | 2053083183 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Southeast Medical Group Llc 1930 Edwards Lake Rd Ste 138 Birmingham AL 35235-3720 Ph: (205) 534-5114 | Southeast Medical Group Llc 1930 Edwards Lake Rd Ste 138b Birmingham AL 35235-3720 Ph: (205) 308-3183 |
NPI Number | 1871059212 |
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Provider Enumeration Date | 02/11/2019 |
Last Update Date | 02/11/2019 |
Identifier | Type | State | Issuer |
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1871059212 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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208D00000X | General Practice | (* (Not Available)) | Primary |
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