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General NPI Number Information
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NPI Number | 1659663599
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Entity Type | Organization
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Legal Business Name | HAYMOUNT URGENT CARE
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Dates
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Enumeration Date | 05/11/2011
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Last Update Date | 04/07/2020
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Provider Practice Location Address
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Address Line | 420 OWEN DR
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City | FAYETTEVILLE
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State | NC
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Zip | 28304-3430
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Country | US
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Telephone | 910-484-1210
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Fax | 910-484-1347
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Provider Business Mailing Address
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Address Line | 420 OWEN DR
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City | FAYETTEVILLE
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State | NC
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Zip | 28304-3430
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Country | US
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Telephone | 910-484-1210
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Fax | 910-484-1347
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Authorized Official
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Title or Position | OWNER
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Name | ROBERT ALLEN CLINTON JR.
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Credential | MD
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Telephone | 910-484-1210
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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 | 200400569
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License Number State | NC
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