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NPI Code Detail

MEDICARE: DR. JENNIFER H PURVIS DPM

MEDICARE: DR. JENNIFER H PURVIS DPM
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
1213EP1101XPrimary Podiatric Medicine Podiatrist622NC
2213ES0103XFoot & Ankle Surgery Podiatrist622NC

General Provider Information

NPI Number : 1568484749
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JENNIFER H PURVIS DPM
Provider Business Mailing Address
First Line : 3301 SUNSET AVE
Second Line :
City : ROCKY MOUNT
State : NC
Zip : 27804-3521
Country : US
Telephone Number : 252-443-7114
Fax Number : 252-443-7115
Provider Business Practice Location Address
First Line : 3301 SUNSET AVE
Second Line :
City : ROCKY MOUNT
State : NC
Zip : 27804-3521
Country : US
Telephone Number : 252-443-7114
Fax Number : 252-443-7115
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/24/2006
Last Update Date : 12/02/2015

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