# SOUTHERN CLINICS AND URGENT CARE PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134108905
- **Authorized official:** DR. AUGUSTINE R EZE M.D. (PRESIDENT)
- **Authorized official phone:** (704) 865-2755

## Contact information

- **Practice address:** 502 W KING ST, LL 20, KINGS MOUNTAIN, NC 28086-3362
- **Practice address phone:** (704) 865-2755
- **Practice address fax:** (704) 865-5013
- **Mailing address:** PO BOX 550490, GASTONIA, NC 28055-0490
- **Mailing address phone:** (704) 865-2755
- **Mailing address fax:** (704) 865-5013

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/11/2006
- **Last updated:** 08/22/2020