Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Southeastern Radiology PA

Organization Diagnostic Radiology Physician · NPI 1669476453

Southeastern Radiology PA is a Diagnostic Radiology Physician in Greensboro, North Carolina. Licensed in North Carolina. Registered with an NPI since 2005.

Licensed in
NC
In the registry since
2005
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3801 W Market St
Greensboro, NC 27407-1301
Phone: (336) 852-3300
Fax: (336) 852-0651
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X · Licence 400555 (NC)

Record details

NPI number1669476453
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Dallas Smith — President · (336) 852-3300
NPI enumeratedJune 9, 2005
Last updated in NPPESDecember 8, 2008
Mailing address3801 W Market St, Greensboro, NC 27407-1301

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