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General NPI Number Information
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NPI Number | 1902839632
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Entity Type | Organization
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Legal Business Name | SOUTHPORT URGENT CARE PLLS
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Dates
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Enumeration Date | 07/08/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1456 N HOWE ST SUITE 100
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City | SOUTHPORT
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State | NC
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Zip | 28461-2754
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Country | US
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Telephone | 910-454-8889
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Fax | 910-454-8890
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Provider Business Mailing Address
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Address Line | 1456 N HOWE ST SUITE 100
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City | SOUTHPORT
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State | NC
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Zip | 28461-2754
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Country | US
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Telephone | 910-454-8889
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Fax | 910-454-8890
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Authorized Official
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Title or Position | OWNER
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Name | SCOTT R HITTER
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Credential | PA
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Telephone | 910-454-9989
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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