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General NPI Number Information
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NPI Number | 1578506325
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Entity Type | Organization
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Legal Business Name | SOUTHEASTERN ONCOLOGY ASSOCIATES, PC
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Dates
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Enumeration Date | 06/13/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2018 BROOKWOOD MEDICAL CTR DR CANCER CENTER
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City | BIRMINGHAM
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State | AL
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Zip | 35209-6898
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Country | US
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Telephone | 205-877-2339
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Fax | 205-877-1821
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Provider Business Mailing Address
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Address Line | PO BOX 660928
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City | BIRMINGHAM
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State | AL
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Zip | 35266-0928
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Country | US
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Telephone | 205-879-8294
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Fax | 205-879-8259
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | JUDY A CAMPODONICO
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Credential |
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Telephone | 205-897-8294
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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