=====================================================
General NPI Number Information
=====================================================
NPI Number | 1194888701
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ISAAC A ARTIS JR MD PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/18/2006
-----------------------------------------------------
Last Update Date | 12/29/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 80 HOWELL ST
-----------------------------------------------------
City | GREENVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27834-5316
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 252-756-6986
-----------------------------------------------------
Fax | 252-756-1197
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 7304
-----------------------------------------------------
City | GREENVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27835-7304
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 252-756-6986
-----------------------------------------------------
Fax | 252-756-1197
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. ISAAC AMOS ARTIS JR.
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 252-756-6986
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | 21148
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------