| Mr Justin Thomas Daughtry, DO | |
|
100 Brewster Blvd, Camp Lejeune, NC 28547-2575 | |
| (910) 450-4841 | |
| Not Available |
| Full Name | Mr Justin Thomas Daughtry |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Location | 100 Brewster Blvd, Camp Lejeune, North Carolina |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003059502 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 5101018326 (Michigan) | Primary |
| Entity Name | Emergency Coverage Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1427005008 PECOS PAC ID: 3072412592 Enrollment ID: O20100202000365 |
| Entity Name | Jones Lake Emergency Group, Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1457913287 PECOS PAC ID: 4587093935 Enrollment ID: O20200406001669 |
| Entity Name | Tarheel Emergency Group, Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1386388874 PECOS PAC ID: 6709268576 Enrollment ID: O20220727001462 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Justin Thomas Daughtry, DO 106 Bargate Dr, New Bern, NC 28562-8412 Ph: () - | Mr Justin Thomas Daughtry, DO 100 Brewster Blvd, Camp Lejeune, NC 28547-2575 Ph: (910) 450-4841 |
Matthew Patrick Sullivan, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 100 Brewster Blvd, Naval Hospital, Camp Lejeune, NC 28547 Phone: 910-450-4159 Fax: 910-450-4194 | |
Dr. David Sullivan Axford, DO Emergency Medicine Medicare: Medicare Enrolled Practice Location: 33 Holcomb Blvd, Camp Lejeune, NC 28547 Phone: 910-440-2463 | |
Liam Francis Delahanty, Emergency Medicine Medicare: Medicare Enrolled Practice Location: 100 Brewster Blvd, Camp Lejeune, NC 28547 Phone: 518-860-4677 | |
Dr. Ellie Lee Burns, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 100 Brewster Blvd, Naval Hospital, Camp Lejeune, NC 28547 Phone: 910-450-4159 Fax: 910-450-4194 | |
Joshua David Simons, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 100 Brewster Blvd, Camp Lejeune, NC 28547 Phone: 910-450-4357 | |
Dr. Emanuel Jackson, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 100 Brewster Blvd, Camp Lejeune, NC 28547 Phone: 910-450-4840 |