Basic Information
| Provider Information | |||||||||
| NPI: | 1740870484 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | J ARTHUR DOSHER MEMORIAL HOSPITAL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 924 N HOWE ST | ||||||||
| Address2: | |||||||||
| City: | SOUTHPORT | ||||||||
| State: | NC | ||||||||
| PostalCode: | 284613038 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9104573810 | ||||||||
| FaxNumber: | 9104573842 | ||||||||
| Practice Location | |||||||||
| Address1: | 904 N HOWE ST | ||||||||
| Address2: | |||||||||
| City: | SOUTHPORT | ||||||||
| State: | NC | ||||||||
| PostalCode: | 284613038 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9104573880 | ||||||||
| FaxNumber: | 8557360495 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/26/2021 | ||||||||
| LastUpdateDate: | 05/04/2021 | ||||||||
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| AuthorizedOfficialLastName: | HUGHES | ||||||||
| AuthorizedOfficialFirstName: | BRANDON | ||||||||
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| AuthorizedOfficialTitleorPosition: | FINANCE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 9104544728 | ||||||||
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| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | J ARTHUR DOSHER MEMORIAL HOSPITAL | ||||||||
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| NPICertificationDate: | 05/04/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.