Organization Name: | GOOD SAMARATAN FAMILY PRACTICE & URGENT CARE, PLLC |
NPI Number: | 1033354840 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | G BROOKS (ADMINISTRATOR) |
Mailing Address: | 210 S Clinton Ave Dunn |
State: | NC US |
Postal Code: | 283344907 |
Phone Number: | 9108917767 |
Fax Number: | 9108917769 |
NPI Enumeration Date: | 12/08/2008 |
NPI Last Update Date: | 09/08/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 103575 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |