Provider Demographics
NPI:1831807825
Name:SOUTHEASTERN TRANSITIONAL CARE MANAGEMENT SERVICES
Entity type:Organization
Organization Name:SOUTHEASTERN TRANSITIONAL CARE MANAGEMENT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:DUKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-665-4162
Mailing Address - Street 1:660 LAKELAND EAST DR STE 210
Mailing Address - Street 2:
Mailing Address - City:FLOWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:39232-9777
Mailing Address - Country:US
Mailing Address - Phone:601-665-4162
Mailing Address - Fax:888-799-9237
Practice Address - Street 1:660 LAKELAND EAST DR STE 210
Practice Address - Street 2:
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-9777
Practice Address - Country:US
Practice Address - Phone:601-664-4162
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-09
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty