| 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 |
|---|---|
| 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 |
|---|---|
| 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 |
|---|---|
| Provider Enumeration Date | 02/11/2019 |
| Last Update Date | 02/11/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871059212 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | () | Primary |
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