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General NPI Number Information
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NPI Number | 1558407205
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Entity Type | Organization
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Legal Business Name | ENGLEWOOD OB-GYN ASSOCIATES PA
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Dates
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Enumeration Date | 01/29/2007
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Last Update Date | 04/07/2020
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Provider Practice Location Address
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Address Line | 140 N ENGLEWOOD DR
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City | ROCKY MOUNT
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State | NC
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Zip | 27804-2416
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Country | US
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Telephone | 252-937-6611
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Fax | 252-937-7388
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Provider Business Mailing Address
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Address Line | PO BOX 7695
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City | ROCKY MOUNT
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State | NC
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Zip | 27804
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Country | US
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Telephone | 252-937-6611
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Fax | 252-937-7388
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TOMMY R HARRIS
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Credential | MD
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Telephone | 252-937-6611
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 38079
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License Number State | NC
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