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General NPI Number Information
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NPI Number | 1417910480
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Entity Type | Organization
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Legal Business Name | ROCKY MOUNT NEUROSURGICAL AND SPINE CONSULTANTS, PA
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Dates
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Enumeration Date | 04/10/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2412 PROFESSIONAL DR
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City | ROCKY MOUNT
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State | NC
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Zip | 27804-2253
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Country | US
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Telephone | 252-443-4563
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Fax | 252-443-6461
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Provider Business Mailing Address
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Address Line | PO BOX 7546
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City | ROCKY MOUNT
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State | NC
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Zip | 27804-0546
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Country | US
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Telephone | 252-443-4563
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Fax | 252-443-6461
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. DEBORAH M DEW
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Credential |
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Telephone | 252-443-4563
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State | NC
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