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NPI Code Detail

MEDICARE: JONESVILLE FAMILY MEDICAL CENTER, P.A.

MEDICARE: JONESVILLE FAMILY MEDICAL CENTER, P.A.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician40345NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10178AOTHERNCBCBSNC
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
301916OTHERNCBCBSNC
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1154437598
Entity Type Code : Organization
Provider Name (Legal Business Name) : JONESVILLE FAMILY MEDICAL CENTER, P.A.
Provider Business Mailing Address
First Line : 4000 S SWAIM STREET EXT
Second Line :
City : JONESVILLE
State : NC
Zip : 28642-9418
Country : US
Telephone Number : 336-835-6300
Fax Number : 336-835-4761
Provider Business Practice Location Address
First Line : 4000 S SWAIM STREET EXT
Second Line :
City : JONESVILLE
State : NC
Zip : 28642-9418
Country : US
Telephone Number : 336-835-6300
Fax Number : 336-835-4761
Authorized Official
Title or Position : OFFICER
Name : DR. EVAN A BALLARD
Credential : M.D.
Telephone Number : 336-835-6300
Provider Enumeration Date : 08/21/2006
Last Update Date : 12/11/2007

Similar Medicare Providers

1972589851 — MS. NANCY CAROLYN TRUITT FNP
Practice Location Address:
4000 S SWAIM STREET EXT
JONESVILLE, NC
28642-9418
Practice Phone: 336-835-6300
Practice Fax: 336-835-4761
1922078906 — MR. JAMES E HUBBS DO
Practice Location Address:
4000 S SWAIM STREET EXT
JONESVILLE, NC
28642-9418
Practice Phone: 336-835-6300
Practice Fax: 336-835-4761
1538275912 — EVAN A BALLARD M.D.
Practice Location Address:
4000 S SWAIM STREET EXT
JONESVILLE, NC
28642-9418
Practice Phone: 336-835-6300
Practice Fax: 336-835-4761
1669588901 — LYNN D. KILLON P.A.-C.
Practice Location Address:
4000 S SWAIM STREET EXT
JONESVILLE, NC
28642-9418
Practice Phone: 336-835-6300
Practice Fax: 336-835-4761
1164538567 — THOMAS M. SHELBURNE M.D.
Practice Location Address:
4000 S SWAIM STREET EXT
JONESVILLE, NC
28642-9418
Practice Phone: 336-835-6300
Practice Fax: 336-835-4761
1871609263 — EUGENE WILSON GRIFFIN III M.D.
Practice Location Address:
4000 S SWAIM STREET EXT
JONESVILLE, NC
28642-9418
Practice Phone: 336-835-6300
Practice Fax: 336-835-4761

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