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Contact Information

SOUTHEASTERN SURGERY
144 EAST MAIN STREET
LOGAN, OH43138
 Phone: 740-385-1881
 Fax: 740-385-1875
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinic/Center

261Q00000X
Indicates primary specialty

NPI Profile & details for SOUTHEASTERN SURGERY

NPI Number 1639536089
LBN Legal business name SOUTHEASTERN SURGERY
Authorized official JOHN DEWALT - (SURGEON)
Entity Organization
Organization subpart 1 No
Enumeration date 01/15/2016
Last updated 01/15/2016 - About 10 years ago
Identifiers
OH License # 34. 002686
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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