SOUTHEAST CANCER NETWORK, INC (NPI# 1013140904) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013140904 |
| Entity Type | Organization |
| Organization Name | SOUTHEAST CANCER NETWORK, INC |
| Other Organization Name | CANCER CARE CENTER OF MONTGOMERY JACKSON |
| Practice Address |
1758 Park Pl Suite 301 Montgomery AL 36106-1127 |
| Mailing Address |
1400 Afflink Pl Suite 100 Tuscaloosa AL 35406-2289 |
| Practice Telephone | 2053669740 |
| Practice Fax Number | 2053449992 |
| Mailing Telephone | 2053669740 |
| Mailing Fax Number | 2053449992 |
| Enumeration Date | 2009-08-26 |
| Last Update Date | 2009-08-26 |
| Authorized Official Name | STEVE L MITCHELL (CFO) |
| Authorized Official Telephone | 2053669740 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Cancer Care Center of Montgomery Jackson | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609072537 | Southeast Cancer Network, Inc | Internal Medicine | 105 Highway 80 E., Demopolis, AL 36732 | 2007-06-26 |
| 1578633566 | Southeast Cancer Network, Inc | Internal Medicine | 2505 Us Hwy 431, Boaz, AL 35957 | 2006-11-08 |
| 1215007273 | Southeast Cancer Network, Inc | Internal Medicine | 3500 Hwy 78 East, Jasper, AL 35501 | 2006-11-08 |
| 1063581536 | Southeast Cancer Network, Inc | Internal Medicine | 171 Caraway Dr, Winfield, AL 35594-5067 | 2006-11-07 |
| 1790854255 | Southeast Cancer Network, Inc | Internal Medicine | 22281 Us Highway 72, Ste B, Athens, AL 35613-2600 | 2006-11-07 |
| 1245472356 | Southeast Cancer Network, Inc | Internal Medicine | 171 Town Center Dr, Suite Mps-6, Anniston, AL 36205-4101 | 2009-04-03 |
| 1295807857 | Southeast Cancer Network, Inc | Internal Medicine | 1410 Mcfarland Blvd N, Tuscaloosa, AL 35406-2209 | 2006-11-15 |
| 1235208778 | Southeast Cancer Network, Inc | Internal Medicine | 1024 1st St N, Alabaster, AL 35007-8703 | 2006-11-07 |
| 1780753418 | Southeast Cancer Network, Inc | Internal Medicine | 300 Saint Lukes Dr, Montgomery, AL 36117-7102 | 2006-11-07 |
| 1255400834 | Southeast Cancer Network, Inc | Internal Medicine | 2055 E South Blvd, Ste 202, Montgomery, AL 36116-2001 | 2006-11-07 |
| Street Address |
1758 PARK PL SUITE 301 |
| City | MONTGOMERY |
| State | AL |
| Zip Code | 36106-1127 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699765271 | Howard L Brazil | Specialist | 1758 Park Pl, Montgomery, AL 36106-1133 | 2005-10-25 |
| 1407387848 | Jackson Hospital and Clinic Inc | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1758 Park Pl, Suite 202, Montgomery, AL 36106-1127 | 2017-03-27 |
| 1578003745 | Jackson Hospital and Clinic Inc. | Internal Medicine | 1758 Park Pl, Suite 406, Montgomery, AL 36106-1127 | 2017-03-07 |
| 1194261669 | Jackson Hospital and Clinic Inc. | Internal Medicine | 1758 Park Pl, Suite 402, Montgomery, AL 36106-1127 | 2017-01-09 |
| 1912362773 | Jackson Hospital and Clinic Inc | Internal Medicine | 1758 Park Pl, Suite 401, Montgomery, AL 36106-1127 | 2015-12-22 |
| 1558764266 | Jackson Hospital and Clinic Inc | Obstetrics & Gynecology | 1758 Park Pl, Suite 301, Montgomery, AL 36106-1127 | 2014-10-08 |
| 1528475084 | William Saliski | Nurse Practitioner | 1758 Park Pl, Ste 300, Montgomery, AL 36106-1127 | 2014-07-16 |
| 1093068900 | Stewart H Tankersley, Md, LLC | Clinic/Center | 1758 Park Pl, Suite 200, Montgomery, AL 36106-1127 | 2012-10-17 |
| 1841576915 | Shelley Sanders Byrd | Nurse Practitioner | 1758 Park Pl, Suite 100, Montgomery, AL 36106-1127 | 2011-11-02 |
| 1346566700 | Latoya Shantel Clark | Obstetrics & Gynecology | 1758 Park Pl, Suite 406, Montgomery, AL 36106-1127 | 2010-04-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235747205 | Rural Urgent Care LLC | Clinic/Center | 3039 Vaughn Road, Montgomery, AL 36106 | 2020-07-16 |
| 1548733306 | Bennett Family Dentistry, LLC | Dentist | 4270 Carmichael Road, Montgomery, AL 36106 | 2019-01-04 |
| 1588133854 | Lori Leanne Fail | Physical Therapist | 1615 Windsor Hill Court, Montgomery, AL 36106 | 2018-11-16 |
| 1073020749 | Charlene Richmond Harrell | Chiropractor | 2900 Zelda Rd., Suite A, Montgomery, AL 36106 | 2018-01-03 |
| 1780123109 | Montgomery Accident and Injury Center, Inc | Nurse Practitioner | 2900 Zelda Rd, Ste B, Montgomery, AL 36106 | 2017-02-17 |
| 1467843573 | Ernest Porterfield | Non-emergency Medical Transport (VAN) | 4183 Carmichael Road, Suite A, Montgomery, AL 36106 | 2015-02-11 |
| 1114334281 | Daniel Gerald O'bryant | Specialist/Technologist | 1160 Navarro Avenue, Montgomery, AL 36106 | 2014-07-21 |
| 1801213764 | Amanda Hodge | Specialist/Technologist | 4605 Cherry Tree Terrace, Montgomery, AL 36106 | 2014-03-27 |
| 1871861542 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1758 Park Pl Ste 102, Montgomery, AL 36106 | 2011-12-08 |
| 1578862546 | Helping Hands Preventitive Health Center | Community/Behavioral Health | 2015 Mulberry St, Montgomery, AL 36106 | 2011-03-16 |
| Find all providers in zip 36106 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417222720 | The Health Care Authority for Baptist Health, An Affiliate of Uabhs | Internal Medicine | 4145 Carmichael Rd, Montgomery, AL 36106-2803 | 2012-03-20 |
| 1740578905 | Astrid Belalcazar | Internal Medicine | 300 Saint Lukes Dr, Montgomery, AL 36117-7102 | 2011-07-21 |
| 1679786354 | John Edward Reardon | Internal Medicine | 4145 Carmichael Road, Montgomery Cancer Center, Montgomery, AL 36106-2803 | 2007-05-08 |
| 1780753418 | Southeast Cancer Network, Inc | Internal Medicine | 300 Saint Lukes Dr, Montgomery, AL 36117-7102 | 2006-11-07 |
| 1255400834 | Southeast Cancer Network, Inc | Internal Medicine | 2055 E South Blvd, Ste 202, Montgomery, AL 36116-2001 | 2006-11-07 |
| 1780623850 | Scott A Mcdaniel | Internal Medicine | 4145 Carmichael Rd, Montgomery, AL 36106 | 2006-06-05 |
| 1902852171 | Stephen L Davidson | Internal Medicine | 4145 Carmichael Rd, Montgomery, AL 36106 | 2006-05-26 |
| 1841246022 | Keith A Thompson | Internal Medicine | 4145 Carmichael Road, Montgomery, AL 36106-2801 | 2006-05-26 |
| 1356395214 | Harry M Barnes IIi | Internal Medicine | 4145 Carmichael Road, Montgomery, AL 36106-2801 | 2006-05-22 |
| 1053303602 | William Gary Cumbie Jr. | Internal Medicine | 1722 Pine St, Ste 500, Montgomery, AL 36106-1103 | 2005-08-19 |
| Find all providers in MONTGOMERY | ||||
| City | MONTGOMERY |
| Zip Code | 36106 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.