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General NPI Number Information
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NPI Number | 1407843014
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Entity Type | Organization
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Legal Business Name | SOUTHEASTERN EYE CARE, PA
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Dates
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Enumeration Date | 09/29/2005
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Last Update Date | 03/13/2025
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Provider Practice Location Address
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Address Line | 106 FARM BROOK DR SUITE B
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City | LUMBERTON
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State | NC
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Zip | 28358-2178
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Country | US
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Telephone | 910-738-4856
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Fax | 910-738-7999
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Provider Business Mailing Address
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Address Line | 106 FARM BROOK DR SUITE B
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City | LUMBERTON
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State | NC
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Zip | 28358-2178
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Country | US
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Telephone | 910-738-4856
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Fax | 910-738-7999
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Authorized Official
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Title or Position | OPHTHALMOLOGIST
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Name | DR. TIMOTHY SCOTT MOUSER
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Credential | M.D.
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Telephone | 910-738-4856
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State | NC
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