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SOUTHEAST MEDICAL GROUP LLC
NPI 1871059212
General Practice in Birmingham, AL

Active since February 11, 2019
1930 EDWARDS LAKE RD STE 138B, BIRMINGHAM, AL 35235(205) 308-3183(205) 278-6939 Get Directions Write a Review

NPPES record last updated: February 11, 2019. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Southeast Medical Group Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHEAST MEDICAL GROUP LLC (NPI 1871059212) is a healthcare organization registered as a general practice in Birmingham, Alabama and active in the NPI registry since February 2019. The organization lists Doug Randall, Managing Member, as its authorized official.

NPPES Registry Identity

NPI1871059212
Entity TypeOrganization
Primary Taxonomy208D00000X
Legal Business NameSOUTHEAST MEDICAL GROUP LLC
Location Address1930 EDWARDS LAKE RD STE 138BBirmingham, AL 35235-3720
Mailing Address1930 Edwards Lake Rd Ste 138Birmingham, AL 35235-3720 · (205) 534-5114 · Fax (205) 278-6939
Phone(205) 308-3183
Fax(205) 278-6939
Organization SubpartNo
Authorized OfficialDoug RandallManaging Member · (205) 308-3183
Enumeration DateFebruary 11, 2019
✔ NPI 1871059212 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

1930 EDWARDS LAKE RD STE 138B, Birmingham, AL 35235
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Southeast Medical Group LLC's NPI number?

The NPI number for Southeast Medical Group LLC is 1871059212. It was assigned to this organization in the NPPES registry on February 11, 2019.

Where is Southeast Medical Group LLC located?

Southeast Medical Group LLC is located at 1930 Edwards Lake Rd Ste 138B, Birmingham, AL 35235. The listed phone number is (205) 308-3183.

What is Southeast Medical Group LLC's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

When was this NPI record last updated?

The NPPES record for Southeast Medical Group LLC was last updated on February 11, 2019. NPI Profile syncs with the weekly NPPES data releases published by CMS.