FAIRMONT MEDICAL CLINIC
NPI 1659508653
Clinic/Center - Rural Health in Fairmont, NC

Q: What is Southeastern Regional Physician Services's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

Active since June 17, 2009

101 N WALNUT ST, FAIRMONT, NC 28340(910) 628-0655(910) 738-3764 Get Directions Write a Review

NPPES record last updated: June 17, 2009. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Fairmont Medical Clinic NPPES

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

FAIRMONT MEDICAL CLINIC (NPI 1659508653) is a healthcare organization registered as a rural health in Fairmont, North Carolina and active in the NPI registry since June 2009. The organization lists Charles T. Johnson, Cfo, as its authorized official.

NPPES Registry Identity

NPI1659508653

Entity TypeOrganization

Primary Taxonomy261QR1300X

Legal Business NameSOUTHEASTERN REGIONAL PHYSICIAN SERVICES

Location Address101 N WALNUT STFairmont, NC 28340-1951

Mailing Address2600 N Elm StLumberton, NC 28358-3011 · (910) 272-3051 · Fax (910) 738-3764

Phone(910) 628-0655

Fax(910) 738-3764

Organization SubpartNo

Authorized OfficialCharles T. JohnsonCfo · (910) 671-5090

Enumeration DateJune 17, 2009

✔ NPI 1659508653 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities

Taxonomy Code261QR1300X

License✔ Licensed in NC · H0064

101 N WALNUT ST, Fairmont, NC 28340

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Other Names 1

Doing Business AsFairmont Medical Clinic

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.

SOUTHEASTERN REGIONAL MEDICAL CENTER

Clinic/Center (Rural Health)