SOUTHEASTERN REGIONAL PHYSICIAN SERVICES NPI 1629469895

NPI Information

  • NPI: 1629469895
  • Provider Name: SOUTHEASTERN REGIONAL PHYSICIAN SERVICES
  • Classification: General Practice - 208D00000X
  • Entity Type: Organization
  • :
  • CLIA Number: 34D2093829
  • Address: 730 OAKRIDGE BLVD
    LUMBERTON, NC
    ZIP 28358
  • Phone: (910) 738-2662

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NPI Details

SOUTHEASTERN REGIONAL PHYSICIAN SERVICES is a general practice in Lumberton, NC. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee SOUTHEASTERN REGIONAL PHYSICIAN SERVICES NPI is 1629469895. The provider is registered as an organization entity type and is a single specialty group.
The provider .

The provider's business location address is:

730 OAKRIDGE BLVD
LUMBERTON, NC
ZIP 28358-324
Phone: (910) 738-2662
Fax: (910) 738-3730

The provider's authorized official is Sara Beth Bradley .
The authorized official title is Cfo and has the following contact phone number (910) 671-5297.

The CLIA number assigned to this NPI record is 34D2093829 - other - transition primary care with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 2/10/2015 and was last updated on 4/28/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208D00000XGeneral PracticeYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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