NPI 1104901438

Southeast Alabama Maternity Care Program

Organisation Exclusive Provider Organization Dothan, AL

Practice location

Address: 545 W Main St STE 3, Dothan, AL 36301-1653
Phone: (334) 712-3784
Fax: (334) 712-3249
Mailing address: PO Box 6987, Dothan, AL 36302-6987

Authorised official

Name: Gary Bennett
Title: Director
Phone: (334) 712-3784

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X

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Registry record

NPI: 1104901438
Entity type: Organization
NPI issued: 26 Oct 2006
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.