SOUTHEASTERN SPECIALIST CLINIC
NPI 1487632873
Specialist in Gastonia, NC

Active since January 05, 2006
825 MAJESTIC CT, SUITE F, GASTONIA, NC 28054(704) 867-8975(704) 867-8353 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Southeastern Specialist Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHEASTERN SPECIALIST CLINIC (NPI 1487632873) is a healthcare organization registered as a specialist in Gastonia, North Carolina and active in the NPI registry since January 2006. The organization lists John R. Miles, President/owner, as its authorized official.

NPPES Registry Identity

NPI1487632873
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameSOUTHEASTERN SPECIALIST CLINIC
Location Address825 MAJESTIC CT, SUITE FGastonia, NC 28054-5186
Mailing Address825 Majestic Court, Suite FGastonia, NC 28054 · (704) 867-8975 · Fax (704) 867-8353
Fax(704) 867-8353
Organization SubpartNo
Authorized OfficialJohn R. MilesPresident/owner · (704) 867-8975
Enumeration DateJanuary 5, 2006
Last NPPES UpdateAugust 22, 2020
NPI 1487632873 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License Licensed in NC · 19633
Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

825 MAJESTIC CT, Gastonia, NC 28054

Other Identifiers 1

Medicaid8958807NC

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Dentist (General Practice)
825 MAJESTIC CT, STE. C
GASTONIA, NC 28054
Dentist (General Practice)
825 MAJESTIC CT, STE. C
GASTONIA, NC 28054
Clinic/Center (Dental)
825 MAJESTIC CT, SUITE - C
GASTONIA, NC 28054
Psychiatry & Neurology (Psychiatry)
825 MAJESTIC CT, SUITE A
GASTONIA, NC 28054
Dentist (General Practice)
825 MAJESTIC CT, SUITE C
GASTONIA, NC 28054

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1487632873, enumerated as an "organization" on January 05, 2006.

The provider is located at 825 MAJESTIC CT SUITE F GASTONIA, NC 28054 and the phone number is (704) 867-8975.

Specialist with taxonomy code 174400000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.