Healthcare Provider Details
I. General information
NPI: 1508123571
Provider Name (Legal Business Name): SESSOMS MEDICAL ASSOICATES,LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/16/2012
Last Update Date: 04/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
500 BEAMAN ST
CLINTON NC
28328-2602
US
IV. Provider business mailing address
500 BEAMAN ST
CLINTON NC
28328-2602
US
V. Phone/Fax
- Phone: 910-596-2800
- Fax: 910-592-6518
- Phone: 910-596-2800
- Fax: 910-592-6518
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | 33927 |
| License Number State | NC |
VIII. Authorized Official
Name: DR.
RODNEY
KEVIN
SESSOMS
Title or Position: OWNER
Credential: M.D.
Phone: 910-596-2964