Healthcare Provider Details

I. General information

NPI: 1700068053
Provider Name (Legal Business Name): PEGGY SUE BARNHILL MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2007
Last Update Date: 03/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

630 S MADISON ST
WHITEVILLE NC
28472-4130
US

IV. Provider business mailing address

PO BOX 5 630 SOUTH MADISON STREET
WHITEVILLE NC
28472-0005
US

V. Phone/Fax

Practice location:
  • Phone: 910-642-7463
  • Fax: 910-642-2668
Mailing address:
  • Phone: 910-642-7463
  • Fax: 910-642-2668

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number200200639
License Number StateNC

VIII. Authorized Official

Name: DR. PEGGY S BARNHILL
Title or Position: MEDICAL DOCTOR
Credential: MD
Phone: 910-642-7463