Southeastern Regional Physician Services
Organization Active NPI Clinic/Center · Lumberton, NC
NPI 1053548016 · NPPES record last updated Jun 18, 2009
Key facts
- NPI
- 1053548016
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinic/Center 261Q00000X
- License
- H0064 (NC)
- Legal business name
- SOUTHEASTERN REGIONAL PHYSICIAN SERVICES
- Practice address
- 4308 Ludgate St
Lumberton, NC 28358-2461 - Phone
- (910) 671-9298
- Fax
- (910) 738-3764
- NPI assigned
- Jun 17, 2009
- Organization subpart
- No
Authorized official
- Name
- Charles T. Johnson III
- Title
- Cfo
- Phone
- (910) 671-5090
Corporate family (same tax ID) 37
National Provider Directory
- Tax ID family
- Southeastern ASC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | H0064 | NC | Yes |
Addresses
Primary practice location
4308 Ludgate St
Lumberton, NC 28358-2461
Mailing address
2600 N Elm St
Lumberton, NC 28358-3011
Phone (910) 272-3051
Other names
- Pain Management Clinic
Other providers in Lumberton, NC
- Southeastern Regional Mental Health Center
- Southeastern Regional Physician Services
- Southeastern Regional Physician Services
- Southeastern Regional Physician Services
- Southeastern Regional Physician Services
- Southeastern Regional Physician Services
- Southeastern Regional Physician Services
- Southeastern Regional Physician Services
- Southeastern Regional Physician Services
- Southeastern Regional Physician Services
All providers in Lumberton, NC · Clinic/Center in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 18, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.