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NPI Code Detail

MEDICARE: THE PEDIATRIC CENTER

MEDICARE: THE PEDIATRIC CENTER
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
1261QP2300XPrimary Care Clinic/CenterNC

General Provider Information

NPI Number : 1659485415
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE PEDIATRIC CENTER
Provider Business Mailing Address
First Line : 1914 GLEN MEADE RD
Second Line :
City : WILMINGTON
State : NC
Zip : 28403-6025
Country : US
Telephone Number : 910-762-2651
Fax Number : 910-763-5709
Provider Business Practice Location Address
First Line : 1914 GLEN MEADE RD
Second Line :
City : WILMINGTON
State : NC
Zip : 28403-6025
Country : US
Telephone Number : 910-762-2651
Fax Number : 910-763-5709
Authorized Official
Title or Position : PEDIATRICIAN
Name : DR. ERIC MICHAEL JACKSON
Credential : M.D.
Telephone Number : 910-762-2651
Provider Enumeration Date : 08/18/2006
Last Update Date : 08/06/2007

Similar Medicare Providers

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Practice Location Address:
1914 GLEN MEADE RD
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1225004575 — DR. PATRICK SCOTT EDWARDS MD
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1457320756 — THE PEDIATRIC CENTER, PLLC
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1346336443 — DR. ERIC MICHAEL JACKSON M.D.
Practice Location Address:
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1861521759 — DR. EVAN HUNTER PIERCE DMD
Practice Location Address:
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1841409877 — PATRICK JOSEPH RENTON MD
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Directions to “THE PEDIATRIC CENTER ” Practice Location

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