National Provider Identifier Database

SOUTHEASTERN SURGERY
Clinic/Center

A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).


Contact Information

SOUTHEASTERN SURGERY
144 EAST MAIN STREET
LOGAN, OH43138
Phone: 740-385-1881
Fax: 740-385-1875
Website:
Specialty Taxonomy Code
* Clinic/Center 261Q00000X

* Indicates primary specialty

NPI Profile & details for SOUTHEASTERN SURGERY

NPI Number 1639536089
Legal business name
LBN
SOUTHEASTERN SURGERY
Authorized official JOHN DEWALT - (SURGEON)
Entity Organization
Organization subpart No
Enumeration date 01/15/2016
Last updated 01/15/2016 - About 10 years ago
Sole proprietor1 Not specified
Identifiers
  • OH License #: 34. 002686

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

Reviews for SOUTHEASTERN SURGERY

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