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NPI Code Detail

MEDICARE: JAMES EDWARD FENTON

MEDICARE: JAMES EDWARD FENTON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1226300000XKinesiotherapist
2225100000XPhysical TherapistCP004769TNC
3225100000XPhysical Therapist1173630TX

General Provider Information

NPI Number : 1003926676
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES EDWARD FENTON
Provider Business Mailing Address
First Line : 534 N 35TH ST STE D
Second Line :
City : MOREHEAD CITY
State : NC
Zip : 28557-3184
Country : US
Telephone Number : 252-726-1802
Fax Number : 252-726-1805
Provider Business Practice Location Address
First Line : 534 N 35TH ST STE D
Second Line :
City : MOREHEAD CITY
State : NC
Zip : 28557-3184
Country : US
Telephone Number : 252-726-1802
Fax Number : 252-726-1805
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2006
Last Update Date : 04/13/2021

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Directions to “ JAMES EDWARD FENTON ” Practice Location

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