| Jacksonville Family Medical Center, Pllc | |
|
2587 Henderson Dr Jacksonville NC 28546-5253 | |
| (910) 938-3200 | |
| (910) 938-3043 |
| Full Name | Jacksonville Family Medical Center, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 2587 Henderson Dr, Jacksonville, North Carolina |
| Authorized Official Name and Position | Ricky A Thomas (PHYSICIAN) |
| Authorized Official Contact | 9109383200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jacksonville Family Medical Center, Pllc 2587 Henderson Dr Jacksonville NC 28546-5253 Ph: (910) 938-3200 | Jacksonville Family Medical Center, Pllc 2587 Henderson Dr Jacksonville NC 28546-5253 Ph: (910) 938-3200 |
| NPI Number | 1104925056 |
|---|---|
| Provider Enumeration Date | 09/21/2006 |
| Last Update Date | 05/09/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104925056 | NPI | - | NPPES |
| DG9898 | Other | NC | RAILROAD MEDICARE PIN |
| 89011JH | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 36058 (North Carolina) | Primary |
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