| Southeast Psychiatric Services | |
|
2812 Hartford Hwy Ste 1 Dothan AL 36305-4927 | |
| (334) 712-1170 | |
| (334) 460-8391 |
| Full Name | Southeast Psychiatric Services |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 2812 Hartford Hwy Ste 1, Dothan, Alabama |
| Authorized Official Name and Position | Nancy A Gilley (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 3347121170 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southeast Psychiatric Services 2812 Hartford Hwy Ste 1 Dothan AL 36305-4927 Ph: (334) 712-1170 | Southeast Psychiatric Services 2812 Hartford Hwy Ste 1 Dothan AL 36305-4927 Ph: (334) 712-1170 |
| NPI Number | 1033495221 |
|---|---|
| Provider Enumeration Date | 11/01/2011 |
| Last Update Date | 12/22/2020 |
| Certification Date | 12/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033495221 | NPI | - | NPPES |
| 134225 | Medicaid | AL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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