Healthcare Provider Details

I. General information

NPI: 1629447396
Provider Name (Legal Business Name): DLP MARIA PARHAM PHYSICIAN PRACTICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2015
Last Update Date: 09/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1209 SE INDUSTRY DR
OXFORD NC
27565-5023
US

IV. Provider business mailing address

120 CHARLES ROLLINS RD SUITE 206
HENDERSON NC
27536-2882
US

V. Phone/Fax

Practice location:
  • Phone: 919-603-3275
  • Fax: 919-603-3294
Mailing address:
  • Phone: 252-436-1680
  • Fax: 252-436-6480

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: JESS JUDY
Title or Position: PRESIDENT
Credential:
Phone: 615-920-7000