Healthcare Provider Details

I. General information

NPI: 1790136620
Provider Name (Legal Business Name): MEGHAN CLAIR HUBBARD D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2016
Last Update Date: 11/07/2025
Certification Date: 11/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 N JOHNSON ST
COATS NC
27521-8407
US

IV. Provider business mailing address

25 N JOHNSON ST
COATS NC
27521-8407
US

V. Phone/Fax

Practice location:
  • Phone: 910-897-6423
  • Fax: 910-897-2540
Mailing address:
  • Phone: 910-897-2764
  • Fax: 910-897-2764

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2019-01046
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: