SOUTHEASTERN SURGERY (NPI# 1639536089) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639536089 |
| Entity Type | Organization |
| Organization Name | SOUTHEASTERN SURGERY |
| Practice Address |
144 East Main Street Logan OH 43138 |
| Mailing Address |
12413 State Route 93 N Logan OH 43138-9306 |
| Practice Telephone | 7403851881 |
| Practice Fax Number | 7403851875 |
| Mailing Telephone | 7403853318 |
| Mailing Fax Number | 7403851875 |
| Enumeration Date | 2016-01-15 |
| Last Update Date | 2016-01-15 |
| Authorized Official Name | DR. JOHN DUFFY DEWALT (SURGEON) |
| Authorized Official Telephone | 7403851881 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | 34. 002686 | OH | Ambulatory Health Care Facilities |
| Street Address |
144 EAST MAIN STREET |
| City | LOGAN |
| State | OH |
| Zip Code | 43138 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508869702 | John Duffy Dewalt | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 144 East Main Street, Logan, OH 43138 | 2005-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538667696 | Kelsey Whalen | Social Worker | 541 Sr 93 N, Suite C, Logan, OH 43138 | 2018-01-24 |
| 1144728205 | Raeann Harry-boothe | Counselor | 313 Chieftain Dr, Logan, OH 43138 | 2018-01-24 |
| 1336661784 | Megan Correll | Nurse Practitioner | 541 Sr 664n, Suite C, Logan, OH 43138 | 2017-07-07 |
| 1841735800 | Coler Drug Logan, Ltd | Durable Medical Equipment & Medical Supplies | 21 Hocking Mall, Logan, OH 43138 | 2016-12-30 |
| 1932515418 | Melissa O'harra-brown | Nurse Practitioner | 541 Sr 664 N, Suite C, Logan, OH 43138 | 2014-07-07 |
| 1790198950 | Matthew R Williams | Audiologist | 1323 West Hunter St., Logan, OH 43138 | 2014-06-05 |
| 1194138651 | Diles Logan Hearing Center, L.L.C. | Audiologist | 1323 West Hunter Street, Logan, OH 43138 | 2014-06-03 |
| 1205252210 | Shaun Crisp | Occupational Therapy Assistant | 601 Ohio 664, Hocking Valley Community Hospital, Logan, OH 43138 | 2014-03-14 |
| 1467780056 | Natalie Simpson | Licensed Practical Nurse | 583 E Second St, Logan, OH 43138 | 2009-11-20 |
| 1821243262 | Angela Rose Hartbarger | Counselor | 541 St. Rt. 664, Suite C, Logan, OH 43138 | 2008-11-26 |
| Find all providers in zip 43138 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | 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). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790087559 | Cache Valley Medical and Wellness | Clinic/Center | 196 S 100 W, Logan, UT 84321-5233 | 2010-11-30 |
| 1275771883 | Body Balance Chiropractic LLC | Clinic/Center | 944 S Highway 89 # 91, Logan, UT 84321-5436 | 2009-02-04 |
| 1205963105 | Ihc Health Services Inc | Clinic/Center | 1300 N 500 E #130, Logan Regional Orthopedics, Logan, UT 84341-2466 | 2007-02-27 |
| 1154826618 | Ihc Health Services Inc | Clinic/Center | 1350 N 500 E, Logan, UT 84341-2400 | 2018-03-27 |
| 1104346204 | Absolute Care Clinic | Clinic/Center | 112 Bridge St, Logan, WV 25601-3602 | 2017-06-21 |
| 1033572193 | Ihc Health Services Inc | Clinic/Center | 1281 N 600 E, Logan, UT 84341-6988 | 2016-04-05 |
| 1104209188 | Family Eye Care Center Pllc | Clinic/Center | 981 S Main St, Suite 200, Logan, UT 84321-6053 | 2015-07-08 |
| 1417354945 | Ihc Health Services Inc | Clinic/Center | 1350 N 500 E, Logan, UT 84341-2400 | 2014-11-26 |
| 1962801407 | Dana Chiropractic | Clinic/Center | 1219 N 400 E, Logan, UT 84341-2321 | 2014-08-21 |
| 1477680270 | Ihc Health Services Inc | Clinic/Center | 1350 N 500 E, Isom Plastic Surgery, Logan, UT 84341-2400 | 2007-02-27 |
| Find all providers in LOGAN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.