| |
103 S Owen Street Elizabethtown NC 28337 | |
(910) 862-2900 | |
(910) 862-2982 |
Full Name | |
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Speciality | Family Medicine |
Location | 103 S Owen Street, Elizabethtown, North Carolina |
Authorized Official Name and Position | Ronald Wade Cottle (PRESIDENT) |
Authorized Official Contact | 9108622900 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 790 Whiteville NC 28472-0790 Ph: (910) 641-0400 | 103 S Owen Street Elizabethtown NC 28337 Ph: (910) 862-2900 |
NPI Number | 1225133408 |
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Provider Enumeration Date | 09/13/2006 |
Last Update Date | 04/05/2012 |
Identifier | Type | State | Issuer |
---|---|---|---|
1225133408 | NPI | - | NPPES |
7924670 | Medicaid | NC | |
017XT | Other | NC | BCBS OF NC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 30015 (North Carolina) | Primary |
The Man Cave Testosterone And Wellness, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2816 W Broad St, Elizabethtown, NC 28337 Phone: 910-801-0600 | |
Above & Beyond Wellness - Bladen Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 101 S Craig St, Elizabethtown, NC 28337 Phone: 910-991-3060 Fax: 910-226-7566 | |