Organization Name: | WAYNE HEALTH PHYSICIANS |
NPI Number: | 1053661066 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CLYDE LOUIS THOMAS (EXECUTIVE DIRECTOR) |
Mailing Address: | 208 Cox Blvd Suite 100 Goldsboro |
State: | NC US |
Postal Code: | 275349414 |
Phone Number: | 9195874051 |
Fax Number: | 9195801083 |
NPI Enumeration Date: | 09/17/2012 |
NPI Last Update Date: | 04/23/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |