Healthcare Provider Details

I. General information

NPI: 1912718149
Provider Name (Legal Business Name): RONALD ALLIGOOD III MSN, AGNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2025
Last Update Date: 01/19/2025
Certification Date: 01/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3004 TOWER BLVD
DURHAM NC
27707-2542
US

IV. Provider business mailing address

3004 TOWER BLVD
DURHAM NC
27707-2542
US

V. Phone/Fax

Practice location:
  • Phone: 919-490-9800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number5021501
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: