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General NPI Number Information
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NPI Number | 1801899133
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Entity Type | Individual
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Provider Name | WILLIAM JAMES STACKHOUSE M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/31/2005
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Last Update Date | 10/10/2023
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Provider Practice Location Address
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Address Line | 301 N HERMAN ST
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City | GOLDSBORO
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State | NC
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Zip | 27530-2973
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Country | US
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Telephone | 919-731-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 201 COX BLVD
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City | GOLDSBORO
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State | NC
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Zip | 27534-9479
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Country | US
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Telephone | 919-734-9455
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Fax | 919-734-4769
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 24298
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License Number State | NC
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