Organization Name: | KERNODLE CLINIC, INC |
NPI Number: | 1689611022 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KEVIN A BILSON (ADMINISTRATOR) |
Mailing Address: | 1234 Huffman Mill Rd Burlington |
State: | NC US |
Postal Code: | 272158700 |
Phone Number: | 3365381234 |
Fax Number: | 3365846811 |
NPI Enumeration Date: | 06/02/2006 |
NPI Last Update Date: | 10/26/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |