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General NPI Number Information
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NPI Number | 1609926294
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Entity Type | Organization
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Legal Business Name | ATLANTIC FETAL MEDICINE PA
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Dates
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Enumeration Date | 01/12/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 411 WESTERN BLVD STE C
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City | JACKSONVILLE
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State | NC
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Zip | 28546-6822
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Country | US
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Telephone | 910-346-1199
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Fax | 910-346-2551
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Provider Business Mailing Address
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Address Line | PO BOX 1047
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City | WRIGHTSVILLE BEACH
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State | NC
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Zip | 28480-1047
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Country | US
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Telephone | 910-346-1199
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Fax | 910-346-2551
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JEFFREY WARREN WRIGHT
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Credential | MD
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Telephone | 910-346-1199
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VM0101X
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Taxonomy Name | Maternal & Fetal Medicine Physician
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License Number | 87734
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License Number State | NC
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