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General NPI Number Information
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NPI Number | 1942206958
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Entity Type | Individual
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Provider Name | BENNIE L JARVIS M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/23/2005
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Last Update Date | 10/16/2024
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Provider Practice Location Address
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Address Line | 400 NASH MEDICAL ARTS MALL
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City | ROCKY MOUNT
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State | NC
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Zip | 27804-1415
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Country | US
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Telephone | 252-962-5300
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Fax | 252-962-5309
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Provider Business Mailing Address
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Address Line | 5221 PARAMOUNT PKWY STE 220
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City | MORRISVILLE
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State | NC
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Zip | 27560-5490
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Country | US
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Telephone |
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Fax |
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 38988
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207YP0228X
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Taxonomy Name | Pediatric Otolaryngology Physician
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License Number | 38988
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 207YS0012X
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Taxonomy Name | Sleep Medicine (Otolaryngology) Physician
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License Number | 38988
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 207YX0602X
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Taxonomy Name | Otolaryngic Allergy Physician
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License Number | 38988
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License Number State | NC
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Taxonomy #5
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 38988
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License Number State | NC
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