Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Southport Surgical Associates, PA

Organization Surgery Physician · NPI 1760693618

Southport Surgical Associates, PA provides Surgery Physician services 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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