Southeastern Clinics LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

SOUTHEASTERN CLINICS LLC

Practice address

114 Hamric Dr E Ste 5
Oxford, AL 36203-2434

Phone

(256) 403-5662

Fax

(256) 403-5673

NPI assigned

Oct 7, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. David Gray

Title

Administrator

Phone

(256) 310-3015

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1412640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412640000000",
    "number": "1396148169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 HAMRIC DR E STE 5",
            "city": "OXFORD",
            "state": "AL",
            "postal_code": "362032434",
            "telephone_number": "256-403-5662",
            "fax_number": "256-403-5673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 HAMRIC DR E STE 5",
            "city": "OXFORD",
            "state": "AL",
            "postal_code": "362032434",
            "telephone_number": "256-403-5662",
            "fax_number": "256-403-5673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN CLINICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-07",
        "last_updated": "2014-10-07",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "256-310-3015",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Oxford, AL
• Providers in Oxford, AL by specialty
• General Practice Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2014; 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.