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General NPI Number Information
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NPI Number | 1801343819
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Entity Type | Organization
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Legal Business Name | FOUR COUNTY ORTHOPEDICS PA
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Dates
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Enumeration Date | 09/07/2016
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Last Update Date | 09/23/2016
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Provider Practice Location Address
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Address Line | 103 PROFESSIONAL PARK DRIVE SUITE C
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City | OXFORD
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State | NC
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Zip | 27565
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Country | US
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Telephone | 919-690-3020
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1554
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City | OXFORD
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State | NC
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Zip | 27565-1554
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Country | US
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Telephone | 252-430-4475
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RAFAEL E. NEGRON-MEDINA
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Credential | MD
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Telephone | 252-430-4475
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 2008-00411
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License Number State | NC
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