Healthcare Provider Details

I. General information

NPI: 1548510407
Provider Name (Legal Business Name): REX PHYSICIANS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2012
Last Update Date: 07/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

790 SE CARY PKWY SUITE 110
CARY NC
27511-5678
US

IV. Provider business mailing address

790 SE CARY PKWY SUITE 110
CARY NC
27511-5678
US

V. Phone/Fax

Practice location:
  • Phone: 919-784-7400
  • Fax: 919-784-7405
Mailing address:
  • Phone: 919-784-7400
  • Fax: 919-784-7405

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: BERNADETTE M SPONG
Title or Position: CFO
Credential:
Phone: 919-784-3245