# SOUTHEASTERN REGIONAL PHYSICIAN SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Southeastern Arthritis Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548672504
- **Authorized official:** CHARLES THOMAS JOHNSON III (CRO)
- **Authorized official phone:** (910) 671-5083

## Contact information

- **Practice address:** 4901 DAWN DR STE 2100, LUMBERTON, NC 28360-0005
- **Practice address phone:** (910) 671-8556
- **Practice address fax:** (910) 671-4850
- **Mailing address:** 2002 N CEDAR ST STE B, LUMBERTON, NC 28358-3926
- **Mailing address phone:** (910) 272-3048
- **Mailing address fax:** (910) 738-3764

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RR0500X | Rheumatology Physician | H0064 | NC | Yes |

## Other

- **Enumeration date:** 05/27/2014
- **Last updated:** 03/25/2022