Organization Name: | SOUTHEASTERN HEALTH PHYSICIAN SERVICES |
NPI Number: | 1437542206 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | FORDHAM B BRITT (DIRECTOR) |
Mailing Address: | 395 W 27th St Lumberton |
State: | NC US |
Postal Code: | 283583018 |
Phone Number: | 9107397551 |
Fax Number: | 9107392332 |
NPI Enumeration Date: | 03/18/2015 |
NPI Last Update Date: | 03/18/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |