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General NPI Number Information
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NPI Number | 1548828965
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Entity Type | Organization
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Legal Business Name | TABOR CITY FAMILY MEDICAL CLINIC, PC
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Dates
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Enumeration Date | 05/31/2019
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Last Update Date | 07/18/2019
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Provider Practice Location Address
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Address Line | 706 E 5TH ST UNIT B
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City | TABOR CITY
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State | NC
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Zip | 28463-2335
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Country | US
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Telephone | 910-207-3697
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Fax |
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Provider Business Mailing Address
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Address Line | 706 E 5TH ST UNIT B
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City | TABOR CITY
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State | NC
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Zip | 28463-2335
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Country | US
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Telephone | 910-377-8002
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Fax | 910-377-8032
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Authorized Official
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Title or Position | OWNER
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Name | FAITH BEKING
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Credential | FNP
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Telephone | 910-377-8002
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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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