| NPI | 1659485415 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC MICHAEL JACKSON Pediatrician 910-762-2651 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NC 2007-01022) |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2007-08-06 |