Southeast Vein & Laser Center, P.C.

Primary specialty

SpecialistTaxonomy code 174400000X

License

15348 Issued in AL

Legal business name

SOUTHEAST VEIN & LASER CENTER, P.C.

Practice address

3280 Ross Clark Cir
Dothan, AL 36303-3040

Phone

(334) 678-9494

Fax

(334) 678-8878

NPI assigned

Jan 10, 2007

Organization subpart

No

Name

Dr. Kenneth L Todd III, M.D., FACPH

Title

President

Phone

(334) 678-9494

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 22, 2020.

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1376693887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3280 ROSS CLARK CIR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363033040",
            "telephone_number": "334-678-9494",
            "fax_number": "334-678-8878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3280 ROSS CLARK CIR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363033040",
            "telephone_number": "334-678-9494",
            "fax_number": "334-678-8878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST VEIN & LASER CENTER, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TODD",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "334-678-9494",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "M.D., FACPH"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "AL",
            "license": "15348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Dothan, AL
• Specialist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.