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General NPI Number Information
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NPI Number | 1790813954
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Entity Type | Organization
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Legal Business Name | HALIFAX X-RAY ASSOCIATES P.A.
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Dates
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Enumeration Date | 03/01/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 19 E 11TH ST
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City | ROANOKE RAPIDS
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State | NC
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Zip | 27870-3840
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Country | US
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Telephone | 252-535-2121
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Fax | 252-535-1011
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Provider Business Mailing Address
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Address Line | PO BOX 249
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City | ROANOKE RAPIDS
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State | NC
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Zip | 27870-0249
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Country | US
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Telephone | 252-535-2121
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Fax | 252-535-1011
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Authorized Official
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Title or Position | PRESIDENT
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Name | BERT PIGGOTT JR.
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Credential | M.D,
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Telephone | 252-535-2121
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 30569
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License Number State | NC
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