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

Southport Surgical Associates, PA

Organization Surgery Physician · NPI 1760693618

Southport Surgical Associates, PA is a Surgery Physician in Southport, North Carolina. Licensed in North Carolina. Registered with an NPI since 2007.

Licensed in
NC
In the registry since
2007
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

621B N Fodale Ave
Southport, NC 28461-3550
Phone: (910) 457-1880
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence 9400669 (NC)

Record details

NPI number1760693618
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Larry Weisner — President · (910) 457-1880
NPI enumeratedMay 24, 2007
Last updated in NPPESAugust 22, 2020
Mailing address621b N Fodale Ave, Southport, NC 28461-3550

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