Healthcare Provider Details

I. General information

NPI: 1396785028
Provider Name (Legal Business Name): JESSE REY NOBLEZA CONSING M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

517 MAIN AVE. WEST
HILDEBRAN NC
28637
US

IV. Provider business mailing address

517 MAIN AVE. WEST
HILDEBRAN NC
28637
US

V. Phone/Fax

Practice location:
  • Phone: 828-397-5561
  • Fax: 828-397-3226
Mailing address:
  • Phone: 828-397-5561
  • Fax: 828-397-3226

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number98-00821
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: