Healthcare Provider Details

I. General information

NPI: 1295926046
Provider Name (Legal Business Name): JAMES MELVIN EYSTER M. D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2007
Last Update Date: 08/07/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4124 BLUE MOUNTAIN RD
OXFORD NC
27565-5408
US

IV. Provider business mailing address

4124 BLUE MOUNTAIN RD
OXFORD NC
27565-5408
US

V. Phone/Fax

Practice location:
  • Phone: 919-603-0600
  • Fax: 919-690-1236
Mailing address:
  • Phone: 919-603-0600
  • Fax: 919-690-1236

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number25794
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: