| |
1002c E 4th Ave, Red Springs, NC 28377-1642 | |
(910) 843-3311 | |
(910) 843-3599 |
Full Name | |
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Type | Facility |
Speciality | Family Medicine |
Location | 1002c E 4th Ave, Red Springs, North Carolina |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1801922901 | NPI | - | NPPES |
7902550 | Medicaid | NC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | (* (Not Available)) | Secondary |
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Kenneth E Locklear |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1275530594 PECOS PAC ID: 8123073566 Enrollment ID: I20050317000916 |
Provider Name | William G Morrozoff |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1437156767 PECOS PAC ID: 8426135062 Enrollment ID: I20080408000125 |
Provider Name | Herman Chavis |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1386630564 PECOS PAC ID: 3678598372 Enrollment ID: I20080520000393 |
Provider Name | Jamie Jones |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1174926612 PECOS PAC ID: 2365765567 Enrollment ID: I20141218002608 |
Mailing Address | Practice Location Address |
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1002c E 4th Ave, Red Springs, NC 28377-1642 Ph: (910) 843-3311 | 1002c E 4th Ave, Red Springs, NC 28377-1642 Ph: (910) 843-3311 |