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Organization
SOUTHEASTERN EYE CARE, PA
Active
Organization
SOUTHEASTERN EYE CARE, PA
Active
Parent organization
SOUTHEASTERN EYE CARE, PA
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTHEASTERN EYE CARE, PA
Authorized official
DR. TIMOTHY SCOTT MOUSER MD (MD, OWNER)
(910) 738-4856
Entity
Organization
Contact information
Practice address
106 FARM BROOK DR, LUMBERTON, NC 28358-2178
(910) 738-4856
(910) 738-7999
Mailing address
106 FARM BROOK DR STE B, LUMBERTON, NC 28358-2178
(910) 738-4856
(910) 738-7999
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
P16942
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2340498
MEDICARE
NC
Enumeration date
02/01/2018
Last updated
02/01/2018
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