STAR MEDICAL CLINIC PLLC NPI 1033565007

NPI Information

NPI: 1033565007
Provider Name: STAR MEDICAL CLINIC PLLC
Classification: General Practice - 208D00000X
Entity Type: Organization

CLIA Number: 34D2117053

Address:
461 WESTERN BLVD STE 122
JACKSONVILLE, NC
ZIP 28546
Phone: (910) 333-0283
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STAR MEDICAL CLINIC PLLC is a general practice in Jacksonville, NC. STAR MEDICAL CLINIC PLLC NPI is 1033565007. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

461 WESTERN BLVD STE 122
JACKSONVILLE, NC
ZIP 28546-637
Phone: (910) 333-0283
Fax: (910) 333-0513

The provider's authorized official is Kevin R Scyoc .
The authorized official title is Ceo and has the following contact phone number (910) 330-2335.

The CLIA number assigned to this NPI record is 34D2117053 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/10/2016 and was last updated on 6/17/2019.

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	Primary
1	207Q00000X	Family Medicine		No
2	207R00000X	Internal Medicine		No
3	261QU0200X	Clinic/Center	Urgent Care	No
4	208D00000X	General Practice		Yes

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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