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General NPI Number Information
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NPI Number | 1811796170
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Entity Type | Organization
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Legal Business Name | WOMBS WINDOW JACKSONVILLE
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Dates
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Enumeration Date | 03/10/2025
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Last Update Date | 03/18/2025
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Provider Practice Location Address
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Address Line | 3780 HENDERSON DR
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City | JACKSONVILLE
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State | NC
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Zip | 28546-5236
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Country | US
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Telephone | 910-548-9149
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Fax | 910-685-7566
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Provider Business Mailing Address
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Address Line | 4608 INDIAN TRL
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City | WILMINGTON
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State | NC
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Zip | 28412-7634
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Country | US
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Telephone | 910-352-6368
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | STEPHANIE PRICE
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Credential |
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Telephone | 910-352-6368
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085U0001X
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Taxonomy Name | Diagnostic Ultrasound Physician
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License Number |
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License Number State |
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