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General NPI Number Information
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NPI Number | 1114080926
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Entity Type | Organization
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Legal Business Name | SOUTHEASTERN CARDIOLOGY CONSULTANTS
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Dates
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Enumeration Date | 12/19/2006
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Last Update Date | 12/21/2022
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Provider Practice Location Address
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Address Line | 2055 E SOUTH BLVD SUITE 403
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City | MONTGOMERY
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State | AL
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Zip | 36116
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Country | US
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Telephone | 334-613-0807
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Fax | 334-386-4175
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Provider Business Mailing Address
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Address Line | 2055 E SOUTH BLVD SUITE 403
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City | MONTGOMERY
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State | AL
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Zip | 36116
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Country | US
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Telephone | 334-613-0807
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Fax | 334-386-4175
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | KAREN W MCCAA
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Credential |
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Telephone | 334-590-7945
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 7842
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License Number State | AL
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