Southern Alabama Physicians LLP

Organization Active NPI Emergency Medicine Physician · Dothan, AL

NPI 1467701490 · NPPES record last updated Nov 27, 2017

Key facts

NPI
1467701490
Entity type
Organization (NPI type 2)
Primary specialty
Emergency Medicine Physician 207P00000X
Legal business name
SOUTHERN ALABAMA PHYSICIANS LLP
Practice address
4370 W Main St
Dothan, AL 36305-1056
Phone
(337) 609-1382
Fax
(334) 793-4613
NPI assigned
Sep 6, 2012
Organization subpart
No

Authorized official

Name
Dr. Derik K King, MD
Title
LLP Managing Partner
Phone
(800) 893-9698

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Practitioners 118

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 118

Medicare participation

Medicare fee-for-service enrollment
Enrolled in AL

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20121003000896 AL Part B Supplier - Clinic/Group Practice 0345499562 Receives reassigned benefits from 116 practitioners
1 other NPI on this enrollment
Practice locations: Enterprise, AL

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207P00000X Yes

Addresses

Primary practice location

4370 W Main St
Dothan, AL 36305-1056

Mailing address

200 Corporate Blvd
Lafayette, LA 70508-3870
Phone (337) 609-1382

Other identifiers

IdentifierTypeStateIssuer
007664700MedicaidFL
142274MedicaidAL

Other providers in Dothan, AL

All providers in Dothan, AL · Emergency Medicine Physician in Alabama

Sources for this page

Verify at the official NPI Registry.