Basic Information
| Provider Information | |||||||||
| NPI: | 1780839076 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | P & S MED | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3294 EAGLE HEIGHTS CIR | ||||||||
| Address2: | |||||||||
| City: | LENOIR | ||||||||
| State: | NC | ||||||||
| PostalCode: | 286459127 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7042482820 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3294 EAGLE HEIGHTS CIR | ||||||||
| Address2: | |||||||||
| City: | LENOIR | ||||||||
| State: | NC | ||||||||
| PostalCode: | 286459127 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7042482820 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/01/2008 | ||||||||
| LastUpdateDate: | 11/13/2009 | ||||||||
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| AuthorizedOfficialLastName: | SOWELL | ||||||||
| AuthorizedOfficialFirstName: | JAMES | ||||||||
| AuthorizedOfficialMiddleName: | RICHARD | ||||||||
| AuthorizedOfficialTitleorPosition: | PRINCIPLE | ||||||||
| AuthorizedOfficialTelephone: | 7042482820 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208D00000X | 9700767 | NC | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | General Practice |
No ID Information.