Organization
SOUTHEASTERN REGIONAL PHYSICIAN SERVICES
Active
Other names
Southeastern Multi-Specialty Clinic Gray's Creek
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES THOMAS JOHNSON (CRO)
(910) 671-5083
Entity
Organization
Contact information
Practice address
1249 CHICKEN FOOT RD STE C, HOPE MILLS, NC 28348-7525
(910) 779-1967
(910) 779-1968
Mailing address
PO BOX 749193, ATLANTA, GA 30374-9193
(984) 974-4372
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
05/13/2021
Last updated
04/28/2025
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