Organization
SOUTHEASTERN SURGERY
Active
Organization
SOUTHEASTERN SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN DUFFY DEWALT DO (SURGEON)
(740) 385-1881
Entity
Organization
Contact information
Practice address
144 EAST MAIN STREET, LOGAN, OH 43138
(740) 385-1881
(740) 385-1875
Mailing address
12413 STATE ROUTE 93 N, LOGAN, OH 43138-9306
(740) 385-3318
(740) 385-1875
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
34. 002686
OH
Other
Enumeration date
01/15/2016
Last updated
01/15/2016
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