| NPI | 1073785622 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH R SMITH Doctor 252-825-1131 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: NC 4119) |
| Enumeration Date | 2008-03-24 |
| Last Update Date | 2014-12-15 |