OrganizationActive
Southeastern Surgery
NPI 1639536089 · Clinic/Center · Logan, OH
Provider details
- NPI number
- 1639536089
- Entity type
- Organization
- Primary specialty
- Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- John Dewalt, Surgeon(740) 385-1881
- License
- 34. 002686 (OH)
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(72/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
10 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
144 East Main Street
Logan, OH 43138
Phone: (740) 385-1881
Fax: (740) 385-1875
Street-level locationGet directions
Mailing address
12413 State Route 93 N
Logan, OH 43138-9306
Registry dates
- Enumerated
- 2016-01-15
- Last updated
- 2016-01-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.