Provider Demographics
NPI:1023430709
Name:SOUTHEAST CLINICAL RESEARCH
Entity type:Organization
Organization Name:SOUTHEAST CLINICAL RESEARCH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:J
Authorized Official - Last Name:PARROTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-490-4816
Mailing Address - Street 1:304 NE 1ST ST
Mailing Address - Street 2:
Mailing Address - City:CHIEFLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32626-1224
Mailing Address - Country:US
Mailing Address - Phone:352-490-4816
Mailing Address - Fax:352-490-8852
Practice Address - Street 1:304 NE 1ST ST
Practice Address - Street 2:
Practice Address - City:CHIEFLAND
Practice Address - State:FL
Practice Address - Zip Code:32626-1224
Practice Address - Country:US
Practice Address - Phone:352-490-4816
Practice Address - Fax:352-490-8852
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-14
Last Update Date:2014-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1100XAmbulatory Health Care FacilitiesClinic/CenterResearch