Southeastern Regional Physician Services
Otolaryngology in Lumberton, NC. Organization (NPI-2).
NPI number1699014191
StatusActive
Last updated in NPPESFeb 5, 2013
Details
- NPI
- 1699014191
- Entity type
- Organization (NPI-2)
- Legal business name
- Southeastern Regional Physician Services
- Organization subpart
- No
- Enumeration date
- Feb 5, 2013
- Last updated
- Feb 5, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Y00000X | Otolaryngology | H0064 | NC | Yes |
Other names
- Southeastern Ear Nose And Throat (Doing Business As)
Practice location
4303 Ludgate StLumberton, NC 28358-2460
Phone 910-738-4226 · Fax 910-738-8844
Mailing address
2600 N Elm StLumberton, NC 28358-3011
Phone 910-671-5290 · Fax 910-738-3764
Authorized official
Michael Ernest Brown
Director
9106715044
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