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620 Dr Calvin Jones Highway Ste 212 Wake Forest NC 27587 | |
| (919) 761-5678 | |
| (919) 761-5680 |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 620 Dr Calvin Jones Highway, Wake Forest, North Carolina |
| Authorized Official Name and Position | Madison Barnett (PROVIDER ENROLLMENT) |
| Authorized Official Contact | 2487818593 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 63103 Charlotte NC 28263-3103 Ph: (866) 557-2612 | 620 Dr Calvin Jones Highway Ste 212 Wake Forest NC 27587 Ph: (919) 761-5678 |
| NPI Number | 1437553302 |
|---|---|
| Provider Enumeration Date | 10/21/2014 |
| Last Update Date | 08/29/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437553302 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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