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Organization

SOUTHEASTERN REGIONAL PHYSICIAN SERVICES

Active
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Organization

SOUTHEASTERN REGIONAL PHYSICIAN SERVICES

Active
Other names
Southeastern Spine & Pain Clinic
Organization subpart
No

Provider details

NPI number
Authorized official
FORDHAM BRITT (DIRECTOR)
(910) 671-5026
Entity
Organization

Contact information

Practice address
4901 DAWN DR STE 3300, LUMBERTON, NC 28360-8288
(910) 671-9298
(910) 671-4850
Mailing address
2002 N CEDAR ST STE B, LUMBERTON, NC 28358-3926
(910) 272-3048
(910) 738-3764

Taxonomy

Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
H0064
NC
261QP3300X
Pain Clinic/Center
H0064
NC

Other

Enumeration date
09/13/2013
Last updated
10/08/2020
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