Basic Information
| Provider Information | |||||||||
| NPI: | 1861681512 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | AVENT | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | THOMAS | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 111 S FAIRVIEW RD | ||||||||
| Address2: | |||||||||
| City: | ROCKY MOUNT | ||||||||
| State: | NC | ||||||||
| PostalCode: | 278016971 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2524463333 | ||||||||
| FaxNumber: | 2524460426 | ||||||||
| Practice Location | |||||||||
| Address1: | 111 S FAIRVIEW RD | ||||||||
| Address2: | |||||||||
| City: | ROCKY MOUNT | ||||||||
| State: | NC | ||||||||
| PostalCode: | 278016971 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2524463333 | ||||||||
| FaxNumber: | 2524460426 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/18/2007 | ||||||||
| LastUpdateDate: | 01/05/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207VG0400X | 20230 | NC | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Gynecology |
ID Information
| ID | Type | State | Issuer | Description | C80952 | 01 | NC | UPIN | OTHER |