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Contact Information

SOUTHEASTERN EMERGENCY SERVICES P C
1114 W MADISON AVE
ATHENS, TN37371
 Phone: 423-745-1411
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nurse Practitioner

363L00000X 50 Nurse Practitioner
 

Medical

363AM0700X 97 Physician Assistant
 

Pediatric Emergency Medicine

207PP0204X 93 Physician/Emergency Medicine
 

Pediatrics

363LP0200X 50 Nurse Practitioner
 

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for SOUTHEASTERN EMERGENCY SERVICES P C

NPI Number 1669414264
LBN Legal business name SOUTHEASTERN EMERGENCY SERVICES P C
Authorized official RANDAL DABBS - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 06/11/2006
Last updated 09/14/2020 - About 6 years ago
Identifiers
AL Medicaid 529929400
KY Medicaid 7100010470
KY Medicaid 78903671
MO Medicaid 507432003
MS Medicaid 02121280
MS Medicaid 05515899
MS Medicaid 06310389
NC Medicaid 2348298
SC Medicaid GP4818
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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