Organization Name: | SOUTH COURT MEDICAL CARE PA |
NPI Number: | 1316345127 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LARRY SYKES (PRESIDENT) |
Mailing Address: | 217 E Elm St Graham |
State: | NC US |
Postal Code: | 272533021 |
Phone Number: | 3362289671 |
Fax Number: | 3362289674 |
NPI Enumeration Date: | 12/10/2014 |
NPI Last Update Date: | 10/28/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 205972 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |