Healthcare Provider Details

I. General information

NPI: 1902855877
Provider Name (Legal Business Name): GOLDSBORO OB-GYN, ASSOCIATES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2006
Last Update Date: 03/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2608 HOSPITAL ROAD
GOLDSBORO NC
27534-9423
US

IV. Provider business mailing address

2608 HOSPITAL ROAD
GOLDSBORO NC
27534-9423
US

V. Phone/Fax

Practice location:
  • Phone: 919-735-3464
  • Fax: 919-735-0080
Mailing address:
  • Phone: 919-735-3464
  • Fax: 919-735-0080

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: DONNA G PERRY
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 919-735-3464