Basic Information
| Provider Information | |||||||||
| NPI: | 1467405431 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | EASTERN CAROLINA PHYSICIANS P.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 744 AIRPORT RD | ||||||||
| Address2: | |||||||||
| City: | KINSTON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 285048800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2525230026 | ||||||||
| FaxNumber: | 2525231855 | ||||||||
| Practice Location | |||||||||
| Address1: | 744 AIRPORT RD | ||||||||
| Address2: | |||||||||
| City: | KINSTON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 285048800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2525230026 | ||||||||
| FaxNumber: | 2525231855 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/18/2006 | ||||||||
| LastUpdateDate: | 08/21/2012 | ||||||||
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| AuthorizedOfficialLastName: | HECK | ||||||||
| AuthorizedOfficialFirstName: | GARY | ||||||||
| AuthorizedOfficialMiddleName: | HERSCHEL | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 2525230026 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | D.O. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 40032 | NC | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 8940896 | 01 | NC | MEDICAID PROVIDER NUMBER | OTHER | 1033105739 | 01 | NC | JOHN JOHN M.D. NPI # | OTHER | 1306832001 | 01 | NC | CHRISTIE WESTBROOK PA | OTHER | 1780670695 | 01 | NC | GARY HECK D.O. NPI # | OTHER | 03216 | 01 | NC | MEDICARE RAILROAD PTAN | OTHER | G79098 | 01 | NC | DR. JOHN K JOHN MEDICARE UPIN | OTHER | 8901960 | 01 | NC | EASTERN CAROLINA PHYSICIANS GROUP MEDICAID FOR KINSTON | OTHER | 5905891 | 01 | NC | DR CABUNGCAL MEDICAID PROVIDER NUMBER | OTHER | P45612 | 01 | NC | MEDICARE UPIN CHRISTIE WESTBROOK PAC | OTHER | 1841234523 | 01 | NPI CABUNGCAL | OTHER | 2064572 | 01 | NC | DR CATHERINE CABUNGCAL MEDICARE PROVIDER NUMBER | OTHER | 5908296 | 01 | NC | EASTERN CAROLINA PHYSICIANS GROUP MEDICAID FOR BEULAVILLE | OTHER | 1043238587 | 01 | NC | S FREDERICK NPI# | OTHER | 1740361369 | 01 | NC | NPI HEATHER TYNDALL | OTHER |