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NPI Code Detail

MEDICARE: MARTIN TYRRELL WASHINGTON DISTRICT HEALTH DEPT

MEDICARE: MARTIN TYRRELL WASHINGTON DISTRICT HEALTH DEPT
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
1261QD0000XDental Clinic/CenterNC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
207059OTHERNCBLUE CROSS

General Provider Information

NPI Number : 1558345983
Entity Type Code : Organization
Provider Name (Legal Business Name) : MARTIN TYRRELL WASHINGTON DISTRICT HEALTH DEPT
Provider Business Mailing Address
First Line : 198 NC HIGHWAY 45 N
Second Line :
City : PLYMOUTH
State : NC
Zip : 27962-9232
Country : US
Telephone Number : 252-793-3023
Fax Number : 252-791-3159
Provider Business Practice Location Address
First Line : 198 NC HIGHWAY 45 N
Second Line :
City : PLYMOUTH
State : NC
Zip : 27962-9232
Country : US
Telephone Number : 252-793-3023
Fax Number : 252-791-3159
Authorized Official
Title or Position : ADMINISTRATIVE ASSISTANT II
Name : RONDA B PHELPS
Credential :
Telephone Number : 252-793-3023
Provider Enumeration Date : 11/30/2005
Last Update Date : 07/21/2022

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198 NC HIGHWAY 45 N
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Practice Location Address:
198 NC HIGHWAY 45 N
PLYMOUTH, NC
27962-9232
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Practice Fax:
1861566408 — MARTIN-TYRRELL-WASHINGTON DISTRICT HEALTH DEPARTMENT
Practice Location Address:
198 NC HIGHWAY 45 N
PLYMOUTH, NC
27962-9232
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Practice Fax:
1891861522 — JOHN ARLIE FRANCIS MD
Practice Location Address:
198 NC HIGHWAY 45 N
PLYMOUTH, NC
27962-9232
Practice Phone: 252-791-3111
Practice Fax: 252-791-3159

Directions to “MARTIN TYRRELL WASHINGTON DISTRICT HEALTH DEPT ” Practice Location

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