| NPI | 1003099409 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES HENRY PRIDGEN Medical Director 910-264-2334 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 29495) |
| Enumeration Date | 2007-12-10 |
| Last Update Date | 2025-07-10 |