Southeastern Specialist Clinic

LBN: Southeastern Specialist Clinic
Southeastern Specialist Clinic is an health care organization with primary practice located at 825 Majestic Ct Suite F, Gastonia NC 28054-5186. The organization recently has only one registered license in Other Service Providers / Specialist, which is considered as the primary health care specialty. Southeastern Specialist Clinic can be contacted via phone (704) 867-8975, or through Miles, John R. via phone (704) 867-8975.

Contact Information

Primary practice address
825 Majestic Ct Suite F Gastonia NC 28054-5186
Phone: (704) 867-8975
Fax: (704) 867-8353
Website:
Map and Directions
Authorized official contact:
Name: Miles, John R. Doctor of Medicine (MD)
Phone: (704) 867-8975

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 19633 North Carolina

Profile Details

NPI number 1487632873
LBN Legal business name Southeastern Specialist Clinic
DBA Doing business as
Authorized official Miles, John R. Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jan 5th, 2006
Last updated Aug 22nd, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487632873 NPPES
North Carolina MEDICAID 8958807

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