Healthcare Provider Details

I. General information

NPI: 1649266891
Provider Name (Legal Business Name): JOHN C ROZIER JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2005
Last Update Date: 10/30/2020
Certification Date: 10/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

295 W 27TH ST
LUMBERTON NC
28358-3016
US

IV. Provider business mailing address

2002 N CEDAR ST STE B
LUMBERTON NC
28358-3926
US

V. Phone/Fax

Practice location:
  • Phone: 910-739-5550
  • Fax: 910-739-3550
Mailing address:
  • Phone: 910-272-3048
  • Fax: 910-738-3764

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number15572
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: