Healthcare Provider Details

I. General information

NPI: 1487753182
Provider Name (Legal Business Name): SESSOMS MEDICAL ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 09/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 BEAMAN STREET
CLINTON NC
28328
US

IV. Provider business mailing address

500 BEAMAN ST
CLINTON NC
28328-2602
US

V. Phone/Fax

Practice location:
  • Phone: 910-596-2800
  • Fax:
Mailing address:
  • Phone: 910-290-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number33927
License Number StateNC

VIII. Authorized Official

Name: DR. RODNEY KEVIN SESSOMS
Title or Position: SEC
Credential: M.D.
Phone: 910-596-2800