| Jacksonville Digestive Diseases Clinic Pa | |
|
224 Memorial Dr Suite A Jacksonville NC 28546 | |
| (910) 577-1444 | |
| (910) 577-1001 |
| Full Name | Jacksonville Digestive Diseases Clinic Pa |
|---|---|
| Speciality | Internal Medicine - Gastroenterology |
| Location | 224 Memorial Dr, Jacksonville, North Carolina |
| Authorized Official Name and Position | Clarita Q Issa (CORP SEC) |
| Authorized Official Contact | 9105771444 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jacksonville Digestive Diseases Clinic Pa 224 Memorial Dr Suite A Jacksonville NC 28546 Ph: (910) 577-1444 | Jacksonville Digestive Diseases Clinic Pa 224 Memorial Dr Suite A Jacksonville NC 28546 Ph: (910) 577-1444 |
| NPI Number | 1861506545 |
|---|---|
| Provider Enumeration Date | 08/18/2006 |
| Last Update Date | 11/14/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861506545 | NPI | - | NPPES |
| 45475 | Other | NC | BC |
| 8945475 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | 22581 (North Carolina) | Primary |
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