| George Hurst Provosty, MD | |
|
209 West 27th Street, Lumberton, NC 28358-3016 | |
| (910) 738-8222 | |
| (910) 671-0846 |
| Full Name | George Hurst Provosty |
|---|---|
| Gender | Male |
| Speciality | Radiology - Diagnostic Radiology |
| Location | 209 West 27th Street, Lumberton, North Carolina |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922091115 | NPI | - | NPPES |
| 69325 | Other | NC | BLUE CROSS BLUE SHIELD |
| 8969325 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | 000018135 (North Carolina) | Secondary |
| 2085R0202X | Radiology - Diagnostic Radiology | 18135 (North Carolina) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| George Hurst Provosty, MD P.o. Box 1527, Lumberton, NC 28359-1527 Ph: (910) 738-8222 | George Hurst Provosty, MD 209 West 27th Street, Lumberton, NC 28358-3016 Ph: (910) 738-8222 |
Thomas Lorenzo Walden Jr., M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 1200 Pine Run Dr, Lumberton, NC 28358 Phone: 910-671-5730 Fax: 910-671-5732 | |
Dr. Andrew Edward Simays, M.D. Radiology Medicare: Medicare Enrolled Practice Location: 209 West 27th Street, Lumberton, NC 28358 Phone: 910-738-8222 Fax: 910-671-0846 | |
Mack Ira Mcclain, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 209 West 27th Street, Lumberton, NC 28358 Phone: 910-738-8222 Fax: 910-671-0846 | |
Robert J Cherichella, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 304 Grande Oak Blvd W, Suite B, Lumberton, NC 28358 Phone: 910-674-4579 Fax: 910-674-4579 | |
Dr. Thomas David Fisher, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 209 West 27th Street, Lumberton, NC 28358 Phone: 910-738-8222 Fax: 910-671-0846 | |
Boyd Bennett Gasque Jr., M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 209 West 27th Street, Lumberton, NC 28358 Phone: 910-738-8222 Fax: 910-671-0846 |