Organization
SOUTHEASTERN REGIONAL PHYSICIAN SERVICES
Active
Other names
Southeastern Medical Clinic Maxton
Organization subpart
No
Provider details
NPI number
Authorized official
FORDHAM B BRITT (DIRECTOR)
(910) 671-5026
Entity
Organization
Contact information
Practice address
22401 ANDREW JACKSON HWY, MAXTON, NC 28364-6721
(910) 844-2004
(910) 844-3798
Mailing address
2600 N ELM ST, LUMBERTON, NC 28358-3011
(910) 272-3051
(910) 738-3764
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
H0064
NC
261QP2300X
Primary Care Clinic/Center
H0064
NC
261QR1300X
Rural Health Clinic/Center
Primary
H0064
NC
Other
Enumeration date
03/11/2014
Last updated
09/26/2016
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