| NPI | 1265165518 |
|---|---|
| Doing Business As | SOUTHEASTERN MULTI-SPECIALTY CLINIC AT GIBSON CANCER CENTER |
| Entity Type | Organization |
| Authorized Contact | CHARLES THOMAS JOHNSON Cro 910-671-5083 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2022-07-05 |
| Last Update Date | 2022-07-05 |