MEDICARE: DR. JEFFREY GERARD COURY DO

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
1	207YS0123X	Facial Plastic Surgery Physician	OS012658	PA

General Provider Information

NPI Number	:	1740312487
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY GERARD COURY DO

Provider Business Mailing Address
First Line	:	333 JEFFERSON ST
Second Line	:
City	:	WHITEVILLE
State	:	NC
Zip	:	28472-3601
Country	:	US
Telephone Number	:	910-914-0540
Fax Number	:	910-914-0640

Provider Business Practice Location Address
First Line	:	333 JEFFERSON ST
Second Line	:
City	:	WHITEVILLE
State	:	NC
Zip	:	28472-3601
Country	:	US
Telephone Number	:	910-914-0540
Fax Number	:	910-914-0640

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/09/2007
Last Update Date	:	01/16/2008

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