| NPI | 1538111414 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHYLLIS AYCOCK WILLIAMS Manager 910-455-7110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine Adult Medicine (Licence: NC 28713) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NC 28713) |
| 101YP1600X Counselor Pastoral (Licence: NC 28713) | |
| 163WG0000X Registered Nurse General Practice (Licence: NC 082155) | |
| 207Q00000X Family Medicine (Licence: NC 28713) | |
| 207QA0401X Family Medicine Addiction Medicine (Licence: NC 28713) | |
| 207VG0400X Obstetrics & Gynecology Gynecology (Licence: NC 28713) | |
| 2083P0901X Preventive Medicine Public Health & General Preventive Medicine (Licence: NC 28713) | |
| 208D00000X General Practice (Licence: NC 28713) | |
| 251S00000X Community/Behavioral Health (Licence: NC 28713) | |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2011-02-28 |