NPI 1053548016

Southeastern Regional Physician Services

Organisation Clinic/Center Lumberton, NC

Practice location

Address: 4308 Ludgate St, Lumberton, NC 28358-2461
Phone: (910) 671-9298
Fax: (910) 738-3764
Mailing address: 2600 N Elm St, Lumberton, NC 28358-3011

Authorised official

Name: Charles T. Johnson
Title: Cfo
Phone: (910) 671-5090

Registered specialties

Clinic/Center Primary

Ambulatory Health Care Facilities Taxonomy 261Q00000X Licence H0064 (NC)

Other Clinic/Center providers in North Carolina →

Registry record

NPI: 1053548016
Entity type: Organization
NPI issued: 17 Jun 2009
Record last updated: 18 Jun 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.