OrganizationActive
Southeastern Surgery
NPI 1639536089 · Clinic/Center · Logan, OH
Southeastern Surgery is a Clinic/Center organization in Logan, OH (NPI 1639536089).
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(73/100 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
Frequently asked questions
- What is Southeastern Surgery's NPI number?
- Southeastern Surgery's National Provider Identifier (NPI) is 1639536089, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Southeastern Surgery?
- Southeastern Surgery is classified in the NPPES registry as Clinic/Center (Ambulatory Health Care Facilities).
- Where is Southeastern Surgery located?
- Southeastern Surgery's practice location on file with NPPES is 144 East Main Street, Logan, OH 43138.
- What is Southeastern Surgery's phone number?
- The practice phone number listed in the NPPES registry for Southeastern Surgery is (740) 385-1881.
- Who is the authorized official for Southeastern Surgery?
- The authorized official listed on Southeastern Surgery's NPPES record is John Dewalt, Surgeon. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Southeastern Surgery's NPI active?
- Yes — Southeastern Surgery's NPI (1639536089) is active in the NPPES registry as of the last update on 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.