Southeastern Pediatric Associates, P.a.
Organization Active NPI Pediatrics Physician · Dothan, AL
NPI 1093907412 · NPPES record last updated Jan 12, 2011
Key facts
- NPI
- 1093907412
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pediatrics Physician 208000000X
- Legal business name
- SOUTHEASTERN PEDIATRIC ASSOCIATES, P.A.
- Practice address
- 364 Honeysuckle Rd
Dothan, AL 36305-1140 - Phone
- (334) 794-8656
- Fax
- (337) 702-7047
- NPI assigned
- Aug 10, 2007
- Organization subpart
- No
Authorized official
- Name
- Mrs. S. Lucy Everett
- Title
- Office Manager
- Phone
- (334) 794-8656
Practitioners 13
-
Craig B Adams, M.D.
-
Claude T Ashley Jr., M.D.
-
Kelly M Ashley, CPNP
-
Angela S Blaxton, M.D.
-
Darrell Wayne Carpenter, M.D.
-
Risha Kahlil Gatlin, M.D.
-
Sarah W Germanson, M.D.
-
Tori Christian Harrison, FNP-C
-
Lauren B Morris, M.D.
-
Jenny Jackson Reid, CRNP
-
John E. Searcy, M.D.
-
Ted A Williams, M.D.
-
Robert A Head, MD
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 01D0304806 | Southeastern Pediatric Associates PA | Compliance | Jan 5, 2027 |
National Provider Directory
Locations
364 Honeysuckle Rd
Dothan, AL 36305
Phone (334) 794-8656
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician |
208000000X | Yes |
Addresses
Primary practice location
364 Honeysuckle Rd
Dothan, AL 36305-1140
Mailing address
364 Honeysuckle Rd
Dothan, AL 36305-1140
Phone (334) 794-8656
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 272658100 | Medicaid | FL | |
| 528300110 | Medicaid | AL |
Other providers in Dothan, AL
- Southeast Outpatient Addiction Recovery
- Southeast Vein & Laser Center, P.C.
- Southeastern Cardiovascular Associates PC
- Southeastern Chiropractic Associates,P.C.
- Southeastern Oral-Maxillofacial and Cosmetic Surgery Center
- Southeastern Psychological and Counseling Services, LLC
- Southeastern Urology, PC
- Southeastern-Oms, LLC
- Southern Alabama Physicians LLP
- Southern Alabama Regional Council on Aging
All providers in Dothan, AL · Pediatrics Physician in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 12, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.