Provider Demographics
NPI:1396824462
Name:LETT, SAMUEL C (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:C
Last Name:LETT
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1107 VOEGLIN AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SELMA
Mailing Address - State:AL
Mailing Address - Zip Code:36703-4301
Mailing Address - Country:US
Mailing Address - Phone:334-875-1440
Mailing Address - Fax:334-875-1446
Practice Address - Street 1:1107 VOEGLIN AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:SELMA
Practice Address - State:AL
Practice Address - Zip Code:36703-4301
Practice Address - Country:US
Practice Address - Phone:334-875-1440
Practice Address - Fax:334-875-1446
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2007-07-09
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Provider Licenses
StateLicense IDTaxonomies
ALAL10319207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALC74876Medicare UPIN