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NPI 1962852848

NPI 1962852848 : AMY-JO BEKONG DO : GARNER, NC

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General NPI Number Information
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    NPI Number           |    1962852848
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    Entity Type          |    Individual 
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    Provider Name        |    AMY-JO BEKONG DO
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/21/2016
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    Last Update Date     |    03/04/2026
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Provider Practice Location Address
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    Address Line         |    605 BENSON RD STE A 
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    City                 |    GARNER
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    State                |    NC
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    Zip                  |    27529-3987
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    Country              |    US
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    Telephone            |    910-994-8125
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    605 BENSON RD STE A 
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    City                 |    GARNER
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    State                |    NC
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    Zip                  |    27529-3987
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    Country              |    US
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    Telephone            |    910-994-8125
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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        |    207Q00000X
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    Taxonomy Name        |    Family Medicine Physician
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    License Number       |    2019-02144
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    License Number State |    NC
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