Basic Information
| Provider Information | |||||||||
| NPI: | 1265010979 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | AMERICAN ARTHRITIS & RHEUMATOLOGY ASSOCIATES-NC PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2255 GLADES RD STE 228W | ||||||||
| Address2: | |||||||||
| City: | BOCA RATON | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334317391 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5613498388 | ||||||||
| FaxNumber: | 5613583142 | ||||||||
| Practice Location | |||||||||
| Address1: | 2125 VALLEYGATE DR STE 201 | ||||||||
| Address2: | |||||||||
| City: | FAYETTEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283043754 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9103231322 | ||||||||
| FaxNumber: | 9103231510 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/01/2021 | ||||||||
| LastUpdateDate: | 04/01/2021 | ||||||||
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| AuthorizedOfficialLastName: | FOWLER | ||||||||
| AuthorizedOfficialFirstName: | JACK | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | VP | ||||||||
| AuthorizedOfficialTelephone: | 5613498388 | ||||||||
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| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | AMERICAN ARTHRITIS & RHEUMATOLOGY ASSOCIATES-NC PLLC | ||||||||
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| NPICertificationDate: | 03/10/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RR0500X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology |
No ID Information.