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Contact Information

SOUTHEASTERN EMERGENCY PHYSICIANS LLC
989 MEDICAL PARK DR
MAYSVILLE, KY41056-8750
 Phone: 606-759-5311
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
 

Clinical Medical Laboratory

291U00000X 69 Clinical Laboratory
 

Hospitalist

208M00000X
 

Medical

363AM0700X 97 Physician Assistant
 

Nurse Practitioner

363L00000X 50 Nurse Practitioner
 

Pediatric Emergency Medicine

207PP0204X 93 Physician/Emergency Medicine
 

Pediatric Emergency Medicine

2080P0204X 37 Physician/Pediatric Medicine
 

Pediatrics

363LP0200X 50 Nurse Practitioner
 

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for SOUTHEASTERN EMERGENCY PHYSICIANS LLC · (Female)

NPI # 1356379382
Status Active
Credentials
Entity Individual
Enumeration date 06/29/2006
Last updated 02/08/2024 - About 2 years ago
Sole proprietor 1 Not specified
Identifiers
  • AL Medicaid 529931890
  • AR Medicaid 156473002
  • AR Medicaid 157777002
  • KY Medicaid 65934218
  • KY Medicaid 65937690
  • MO Medicaid 507198802
  • NC Medicaid 5901815
  • NC Medicaid 5902177
  • SC Medicaid GP3694
  • SC Medicaid GP3965
  • TN Medicaid 3728386
  • WV Medicaid 4005131000
  • AR Other 5C346 BS AR
  • NC Other 017E9 BCBS OF NC
  • WV Other 001740238 MOUNTAIN STATES BLUE CROSS
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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