Healthcare Provider Details

I. General information

NPI: 1063505949
Provider Name (Legal Business Name): ONSLOW AMBULATORY SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 04/07/2025
Certification Date: 04/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 OFFICE PARK DR
JACKSONVILLE NC
28546-3219
US

IV. Provider business mailing address

200 MEMORIAL DR
JACKSONVILLE NC
28546-6332
US

V. Phone/Fax

Practice location:
  • Phone: 910-346-5016
  • Fax: 910-577-4987
Mailing address:
  • Phone: 910-577-4703
  • Fax: 910-577-2575

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License NumberAS0039
License Number StateNC

VIII. Authorized Official

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