Organization
NOVANT HEALTH SOUTHEASTERN SPINE INSTITUTE, LLC
Active
Other names
Southeastern Spine Institute
Organization subpart
No
Provider details
NPI number
Authorized official
LEEA WALTON (RCS MANAGER)
(336) 515-7085
Entity
Organization
Contact information
Practice address
1625 HOSPITAL DR, MT PLEASANT, SC 29464-3698
(843) 849-1551
(843) 884-0629
Mailing address
2085 FRONTIS PLAZA BLVD, WINSTON SALEM, NC 27103-5614
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
—
—
207XS0117X
Orthopaedic Surgery of the Spine Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
Other
Enumeration date
11/13/2024
Last updated
04/06/2026
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