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General NPI Number Information
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NPI Number | 1619287182
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Entity Type | Organization
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Legal Business Name | DOWN EAST FAMILY MEDICINE, PLLC
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Dates
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Enumeration Date | 10/18/2010
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Last Update Date | 12/27/2011
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Provider Practice Location Address
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Address Line | 306 BRYNN MARR ROAD
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City | JACKSONVILLE
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State | NC
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Zip | 28546-7023
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Country | US
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Telephone | 910-353-1276
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Fax | 910-353-0967
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Provider Business Mailing Address
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Address Line | 306 BRYNN MARR ROAD
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City | JACKSONVILLE
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State | NC
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Zip | 28546-7023
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Country | US
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Telephone | 910-353-1276
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Fax | 910-353-0967
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | JENNIFER B. PERSON
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Credential | MMS, PA-C
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Telephone | 910-353-1276
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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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