Healthcare Provider Details

I. General information

NPI: 1023638103
Provider Name (Legal Business Name): JOEL BRYANT OUBRE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2020
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2311 DELANEY AVE
WILMINGTON NC
28403-6012
US

IV. Provider business mailing address

2311 DELANEY AVE
WILMINGTON NC
28403-6012
US

V. Phone/Fax

Practice location:
  • Phone: 910-762-8754
  • Fax: 910-762-0778
Mailing address:
  • Phone: 910-762-8754
  • Fax: 910-762-0778

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number202601548
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: