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General NPI Number Information
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NPI Number | 1215007273
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Entity Type | Organization
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Legal Business Name | SOUTHEAST CANCER NETWORK, INC
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 3500 HWY 78 EAST
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City | JASPER
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State | AL
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Zip | 35501
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Country | US
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Telephone | 205-387-8483
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Fax |
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Provider Business Mailing Address
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Address Line | 1400 AFFLINK PL STE 100
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City | TUSCALOOSA
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State | AL
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Zip | 35406-2289
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Country | US
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Telephone | 205-366-9740
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Fax | 205-344-9992
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Authorized Official
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Title or Position | CFO
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Name | STEVE L MITCHELL
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Credential |
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Telephone | 205-366-9740
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number |
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License Number State |
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