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General NPI Number Information
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NPI Number | 1205230430
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Entity Type | Organization
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Legal Business Name | MEDACCESS URGENT CARE, PLLC
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Dates
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Enumeration Date | 10/17/2014
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Last Update Date | 10/17/2014
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Provider Practice Location Address
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Address Line | 700 US 1 HWY STE 100
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City | YOUNGSVILLE
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State | NC
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Zip | 27596-7872
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Country | US
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Telephone | 919-562-2340
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Fax | 919-562-2315
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Provider Business Mailing Address
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Address Line | PO BOX 1811
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City | ROXBORO
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State | NC
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Zip | 27573-1811
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Country | US
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Telephone | 336-330-0400
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Fax | 336-330-0031
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Authorized Official
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Title or Position | COO
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Name | MR. KURT STALNAKER
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Credential | MBA
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Telephone | 919-641-2046
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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