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General NPI Number Information
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NPI Number | 1366346389
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Entity Type | Organization
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Legal Business Name | SOUTHEASTERN INTEGRATED FAMILY MEDICINE INC
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Dates
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Enumeration Date | 10/05/2026
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Last Update Date | 10/05/2026
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Provider Practice Location Address
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Address Line | 201 LIVERMORE DR
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City | PEMBROKE
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State | NC
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Zip | 28372-7322
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Country | US
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Telephone | 910-522-0408
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1572
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City | LUMBERTON
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State | NC
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Zip | 28359-1572
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | VP PROGRAM OPERATIONS
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Name | JHONATHAN MATTHEW STRICKLAND
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Credential |
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Telephone | 910-522-0408
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State | NULL
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State | NULL
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State | NULL
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State | NULL
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