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NPI Code Detail

MEDICARE: JACOB EL-KHOURY

MEDICARE: JACOB EL-KHOURY
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
11223G0001XGeneral Practice Dentistry14243NC

General Provider Information

NPI Number : 1285323576
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACOB EL-KHOURY
Provider Business Mailing Address
First Line : 1130 GODWIN DR
Second Line :
City : WILLIAMSTON
State : NC
Zip : 27892-6828
Country : US
Telephone Number : 252-789-0401
Fax Number :
Provider Business Practice Location Address
First Line : 1130 GODWIN DR
Second Line :
City : WILLIAMSTON
State : NC
Zip : 27892-6828
Country : US
Telephone Number : 252-789-0401
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/03/2023
Last Update Date : 03/13/2026

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Directions to “ JACOB EL-KHOURY ” Practice Location

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