Basic Information
Provider Information
NPI: 1659700144
EntityType: 2
ReplacementNPI:  
OrganizationName: REX HOSPITAL INC
LastName:  
FirstName:  
MiddleName:  
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Credential:  
OtherOrganizationName: REX NEUROSURGERY AND SPINE SPECIALISTS
OtherOrganizationType: 3
OtherLastName:  
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Mailing Information
Address1: 4207 LAKE BOONE TRL STE 220
Address2:  
City: RALEIGH
State: NC
PostalCode: 276076685
CountryCode: US
TelephoneNumber: 9197841410
FaxNumber: 9197841409
Practice Location
Address1: 4207 LAKE BOONE TRL
Address2: SUITE 220
City: RALEIGH
State: NC
PostalCode: 276076684
CountryCode: US
TelephoneNumber: 9197841410
FaxNumber: 9197841409
Other Information
ProviderEnumerationDate: 11/05/2013
LastUpdateDate: 10/12/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: SKALSKY
AuthorizedOfficialFirstName: MEGHAN
AuthorizedOfficialMiddleName: ELIZABETH
AuthorizedOfficialTitleorPosition: DIRECTOR OF CORPORATE FINANCE
AuthorizedOfficialTelephone: 9197847711
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
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NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207T00000X  Y193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansNeurological Surgery 

No ID Information.


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