MEDICARE: DR. JOHN D IRVIN MD

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
1	207Q00000X	Family Medicine Physician	94-01419	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	77610	OTHER	NC	MEDCOST
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	0128762	OTHER	NC	UNITED HEALTHCARE
4	145G6	OTHER	NC	BCBS OF NC

General Provider Information

NPI Number	:	1043207749
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN D IRVIN MD

Provider Business Mailing Address
First Line	:	6407 GREEN ARBOR LN
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28409-2137
Country	:	US
Telephone Number	:	910-470-3888
Fax Number	:

Provider Business Practice Location Address
First Line	:	4654 LONG BEACH RD SE
Second Line	:
City	:	SOUTHPORT
State	:	NC
Zip	:	28461-8799
Country	:	US
Telephone Number	:	910-457-9564
Fax Number	:	910-457-6744

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/29/2005
Last Update Date	:	03/04/2014

Similar Medicare Providers

1356433171 — JOHN SARDELLA PA-C
Practice Location Address:

4654 LONG BEACH RD SE
SOUTHPORT, NC
28461-8799

Practice Phone: 910-457-9564
Practice Fax:

1912127994 — JAMES R FORSTNER
Practice Location Address:

4654 LONG BEACH RD SE
SOUTHPORT, NC
28461-8799

Practice Phone: 910-457-9564
Practice Fax: 910-457-6744

1922414754 — CAROLINA COMPREHENSIVE HEALTH
Practice Location Address:

4654 LONG BEACH RD SE
SOUTHPORT, NC
28461-8799

Practice Phone: 910-457-9564
Practice Fax: 910-457-6744

1548711963 — GOSHEN MEDICAL CENTER INCORPORATED
Practice Location Address:

4654 LONG BEACH RD SE
SOUTHPORT, NC
28461-8799

Practice Phone: 910-457-0070
Practice Fax:

1669328258 — RICCOBENE & ASSOCIATES I, DDS, P.A.
Practice Location Address:

5021 SOUTHPORT CROSSINGS WAY STE 310
SOUTHPORT, NC
28461

Practice Phone: 910-375-9579
Practice Fax:

1215936356 — DOMENIC A PALAGRUTO D.O.
Practice Location Address:

3599 GEORGE II HWY
SOUTHPORT, NC
28461-7793

Practice Phone: 910-845-3244
Practice Fax: 910-845-3276

Directions to “ DR. JOHN D IRVIN MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.