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NPI Code Detail

MEDICARE: RAYMOND KARGO MSPT

MEDICARE: RAYMOND KARGO MSPT
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
1225100000XPhysical Therapist9250NC

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3P00010441OTHERNCMEDICARE RAILROAD
42500795AOTHERNCMEDICARE PHYICAL THERAPY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1C4594OTHERNCMEDCOST
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5078U7OTHERNCBCBS

General Provider Information

NPI Number : 1174504104
Entity Type Code : Individual
Provider Name (Legal Business Name) : RAYMOND KARGO MSPT
Provider Business Mailing Address
First Line : 1915 LENDEW ST
Second Line :
City : GREENSBORO
State : NC
Zip : 27408-7033
Country : US
Telephone Number : 336-275-7405
Fax Number : 336-275-3320
Provider Business Practice Location Address
First Line : 1915 LENDEW STREET
Second Line :
City : GREENSBORO
State : NC
Zip : 27408-7033
Country : US
Telephone Number : 336-275-7405
Fax Number : 336-275-3320
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/08/2005
Last Update Date : 09/28/2012

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Directions to “ RAYMOND KARGO MSPT” Practice Location

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