| Eastern Medical Associates, Pa | |
|
2609 Medical Office Pl Goldsboro NC 27534-9428 | |
| (919) 734-1779 | |
| (919) 734-7570 |
| Full Name | Eastern Medical Associates, Pa |
|---|---|
| Speciality | General Practice |
| Location | 2609 Medical Office Pl, Goldsboro, North Carolina |
| Authorized Official Name and Position | Philip Douglas Mayo (PRESIDENT) |
| Authorized Official Contact | 9197341779 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eastern Medical Associates, Pa 2609 Medical Office Pl Goldsboro NC 27534-9428 Ph: (919) 734-1779 | Eastern Medical Associates, Pa 2609 Medical Office Pl Goldsboro NC 27534-9428 Ph: (919) 734-1779 |
| NPI Number | 1194762807 |
|---|---|
| Provider Enumeration Date | 06/01/2006 |
| Last Update Date | 01/07/2014 |
| Medicare PECOS PAC ID | 3173414109 |
|---|---|
| Medicare Enrollment ID | O20040322000237 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194762807 | NPI | - | NPPES |
| 890112R | Medicaid | NC | |
| CI3418 | Other | NC | MEDICARE RAILROAD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Philip Douglas Mayo |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1275572208 PECOS PAC ID: 1850371733 Enrollment ID: I20040721001451 |
| Provider Name | Dalton Edward Dove |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1447297809 PECOS PAC ID: 4880585819 Enrollment ID: I20040721001549 |
| Provider Name | Daniel Thomas Poole |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1205875234 PECOS PAC ID: 9537185947 Enrollment ID: I20051014000588 |
| Provider Name | Kimberly Rachelle Willis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487852562 PECOS PAC ID: 1759455389 Enrollment ID: I20090917000409 |
| Provider Name | Keith Carmack |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609813146 PECOS PAC ID: 4587791124 Enrollment ID: I20100429001124 |
| Provider Name | Patricia Michelle Childers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871536581 PECOS PAC ID: 0648462697 Enrollment ID: I20101008000233 |
| Provider Name | Stephen A Spencer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750511937 PECOS PAC ID: 5193973667 Enrollment ID: I20120907000612 |
| Provider Name | Veeresh Medlery |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437356565 PECOS PAC ID: 7719065390 Enrollment ID: I20140610000985 |
| Provider Name | Leonard Johnson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609196203 PECOS PAC ID: 8628295680 Enrollment ID: I20140814001899 |
| Provider Name | Aminu Isyaku Mohammed |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205271145 PECOS PAC ID: 6406098599 Enrollment ID: I20140903001211 |
| Provider Name | Jodel Giraud |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881917516 PECOS PAC ID: 1153540646 Enrollment ID: I20140916000454 |
| Provider Name | Sander Fernandez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922394485 PECOS PAC ID: 7618197161 Enrollment ID: I20141003000932 |
| Provider Name | Lauren Jones Lancaster |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033590401 PECOS PAC ID: 5799090965 Enrollment ID: I20150817002594 |
| Provider Name | Carmelia R Carroll |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871979229 PECOS PAC ID: 8426368838 Enrollment ID: I20151113000840 |
| Provider Name | Kelly Hammerbeck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255881983 PECOS PAC ID: 0941580518 Enrollment ID: I20161219000257 |
| Provider Name | Tasha Westbrook Bollin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982112066 PECOS PAC ID: 4183986078 Enrollment ID: I20180312001878 |
| Provider Name | Melanie Diane Tilley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205391711 PECOS PAC ID: 6507108271 Enrollment ID: I20190429001752 |
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