FAYETTEVILLE FAMILY EXTENDED CARE NPI 1710977681

NPI Information

NPI: 1710977681
Provider Name: FAYETTEVILLE FAMILY EXTENDED CARE
Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
1307 AVON ST
FAYETTEVILLE, NC
ZIP 28304
Phone: (910) 323-1718
Get Directions

FAYETTEVILLE FAMILY EXTENDED CARE is a family medicine in Fayetteville, NC. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. FAYETTEVILLE FAMILY EXTENDED CARE NPI is 1710977681. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1307 AVON ST
FAYETTEVILLE, NC
ZIP 28304-423
Phone: (910) 323-1718
Fax: (910) 323-5701

The provider's authorized official is Alice M Kugler .
The authorized official title is Administrator and has the following contact phone number (910) 323-1718.

The enumeration date for this NPI number is 10/24/2005 and was last updated on 4/18/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207Q00000X	Family Medicine			NORTH CAROLINA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	015CY	OTHER	NORTH CAROLINA	BCBS
2	89015CY	MEDICAID	NORTH CAROLINA
3	2349774	MEDICARE PIN	NORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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