Organization
SOUTHEASTERN OVERREAD SERVICES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DALLAS A SMITH JR. M.D. (PRESIDENT)
(336) 542-2900
Entity
Organization
Contact information
Practice address
109 MUIRS CHAPEL RD, LOWER LEVEL, GREENSBORO, NC 27410-6161
(336) 542-2903
(336) 542-2929
Mailing address
PO BOX 4778, GREENSBORO, NC 27404-4778
(336) 542-2903
(336) 542-2929
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
—
—
2085N0904X
Nuclear Radiology Physician
—
—
2085P0229X
Pediatric Radiology Physician
—
—
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
2085U0001X
Diagnostic Ultrasound Physician
—
—
Other
Enumeration date
08/27/2007
Last updated
06/20/2011
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