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NPI Code Detail

MEDICARE: EAGLE PHYSICIANS AND ASSOCIATES PA

MEDICARE: EAGLE PHYSICIANS AND ASSOCIATES PA
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
1363L00000XNurse Practitioner
2207Q00000XFamily Medicine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
202757OTHERNCBCBS OF NC

General Provider Information

NPI Number : 1982773206
Entity Type Code : Organization
Provider Name (Legal Business Name) : EAGLE PHYSICIANS AND ASSOCIATES PA
Provider Business Mailing Address
First Line : PO BOX 14883
Second Line :
City : GREENSBORO
State : NC
Zip : 27415-4883
Country : US
Telephone Number : 336-644-0111
Fax Number : 336-644-0085
Provider Business Practice Location Address
First Line : 1510 NC HIGHWAY 68 N
Second Line :
City : OAK RIDGE
State : NC
Zip : 27310-9733
Country : US
Telephone Number : 336-644-0111
Fax Number : 336-644-0085
Authorized Official
Title or Position : DIRECTOR, EAGLE BUSINESS SERVICES
Name : TERRI S. JONES
Credential :
Telephone Number : 336-268-3201
Provider Enumeration Date : 11/08/2006
Last Update Date : 09/24/2015

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Directions to “EAGLE PHYSICIANS AND ASSOCIATES PA ” Practice Location

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