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General NPI Number Information
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NPI Number | 1639294457
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Entity Type | Organization
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Legal Business Name | CARTERET FAMILY PRACTICE CLINIC
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Dates
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Enumeration Date | 03/20/2007
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Last Update Date | 11/09/2009
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Provider Practice Location Address
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Address Line | 208A PENNY LN
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City | MOREHEAD CITY
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State | NC
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Zip | 28557-4305
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Country | US
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Telephone | 252-247-5177
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Fax | 252-247-0223
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Provider Business Mailing Address
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Address Line | 208A PENNY LN
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City | MOREHEAD CITY
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State | NC
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Zip | 28557-4305
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Country | US
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Telephone | 252-247-5177
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Fax | 252-247-0223
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Authorized Official
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Title or Position | MEDICAL DOCTOR
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Name | DONALD BROOKS REECE II
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Credential | MD
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Telephone | 252-247-5177
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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 | 18559
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number | 18559
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License Number State | NC
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