Healthcare Provider Details

I. General information

NPI: 1033306279
Provider Name (Legal Business Name): ONSLOW AMBULATORY SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2007
Last Update Date: 04/07/2025
Certification Date: 04/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215B STATION ST
JACKSONVILLE NC
28546-6304
US

IV. Provider business mailing address

200 MEMORIAL DR
JACKSONVILLE NC
28546-6332
US

V. Phone/Fax

Practice location:
  • Phone: 910-577-2334
  • Fax: 910-577-2363
Mailing address:
  • Phone: 910-577-4703
  • Fax: 910-577-2575

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number2007-01406
License Number StateNC

VIII. Authorized Official

Name: CARL BIBER
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 910-577-2969