Healthcare Provider Details

I. General information

NPI: 1992765705
Provider Name (Legal Business Name): CARTERET FAMILY PRACTICE CLINIC PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2006
Last Update Date: 01/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208A PENNY LN
MOREHEAD CITY NC
28557-4305
US

IV. Provider business mailing address

208A PENNY LN
MOREHEAD CITY NC
28557-4305
US

V. Phone/Fax

Practice location:
  • Phone: 252-247-5177
  • Fax: 252-247-0223
Mailing address:
  • Phone: 252-247-5177
  • Fax: 252-247-0223

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number18559
License Number StateNC

VIII. Authorized Official

Name: DR. DONALD BROOKS REECE II
Title or Position: DOCTOR
Credential: MD
Phone: 252-247-5177