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General NPI Number Information
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NPI Number | 1194134502
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Entity Type | Organization
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Legal Business Name | COMMUNITY MED ONE
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Dates
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Enumeration Date | 08/11/2014
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Last Update Date | 01/28/2016
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Provider Practice Location Address
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Address Line | 319 HOSPITAL RD
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City | ZEBULON
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State | NC
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Zip | 27597-2542
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Country | US
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Telephone | 910-740-3135
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2614
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City | ROCKINGHAM
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State | NC
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Zip | 28380-2614
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | JESSE HORNE
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Credential |
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Telephone | 910-740-3135
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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