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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

NPI Number 1356379382
LBN Legal business name SOUTHEASTERN EMERGENCY PHYSICIANS LLC
Authorized official MICHAEL CORVINI - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 06/29/2006
Last updated 02/08/2024 - About 2 years ago
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
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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