Healthcare Provider Details

I. General information

NPI: 1841633237
Provider Name (Legal Business Name): SOUTHPOINT SURGICAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2013
Last Update Date: 04/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5309 HIGHGATE DR SUITE 220
DURHAM NC
27713-8501
US

IV. Provider business mailing address

5309 HIGHGATE DR SUITE 220
DURHAM NC
27713-8501
US

V. Phone/Fax

Practice location:
  • Phone: 919-519-9962
  • Fax: 919-896-1708
Mailing address:
  • Phone: 919-519-9962
  • Fax: 919-896-1708

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number200300175
License Number StateNC

VIII. Authorized Official

Name: LYNDA B MCHUTCHISON
Title or Position: SOLE MEMBER
Credential: MD
Phone: 919-519-9962