| Southeast Psychiatry Services, Llc | |
|
182 Boykin Lakes Loop Pike Road AL 36064-3961 | |
| (706) 315-7478 | |
| Not Available |
| Full Name | Southeast Psychiatry Services, Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 182 Boykin Lakes Loop, Pike Road, Alabama |
| Authorized Official Name and Position | Kristy Savage (PARTNER) |
| Authorized Official Contact | 7063157478 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southeast Psychiatry Services, Llc 182 Boykin Lakes Loop Pike Road AL 36064-3961 Ph: (706) 315-7478 | Southeast Psychiatry Services, Llc 182 Boykin Lakes Loop Pike Road AL 36064-3961 Ph: (706) 315-7478 |
| NPI Number | 1467040410 |
|---|---|
| Provider Enumeration Date | 01/05/2021 |
| Last Update Date | 01/22/2021 |
| Certification Date | 01/22/2021 |
| Medicare PECOS PAC ID | 4486061363 |
|---|---|
| Medicare Enrollment ID | O20210319000927 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467040410 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Ella M Williamson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740568443 PECOS PAC ID: 6608048608 Enrollment ID: I20111018000187 |
| Provider Name | Yulanda Renee King |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184214132 PECOS PAC ID: 7416366786 Enrollment ID: I20210518000293 |
| Provider Name | Sunil Dutt Parashar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1518122886 PECOS PAC ID: 9133307507 Enrollment ID: I20211006002262 |
| Provider Name | Sherry R Noble |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982246708 PECOS PAC ID: 5597140988 Enrollment ID: I20220921002437 |
| Provider Name | Randall Campbell |
|---|---|
| Provider Type | Practitioner - Single Or Multispecialty Clinic Or Group Practice |
| Provider Identifiers | NPI Number: 1366030124 PECOS PAC ID: 9830563105 Enrollment ID: I20230607001523 |
| Provider Name | Alexus Cierra Lambert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619694130 PECOS PAC ID: 5496100638 Enrollment ID: I20231009001854 |
| Provider Name | Fillis Walton |
|---|---|
| Provider Type | Practitioner - Other (physician) |
| Provider Identifiers | NPI Number: 1922466218 PECOS PAC ID: 7214388834 Enrollment ID: I20240109000293 |
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