# KEVIN JAY WOLF

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Goldsboro Podiatry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063691301
- **Authorized official:** DR. KEVIN JAY WOLF DPM (OWNER)
- **Authorized official phone:** (919) 583-9788

## Contact information

- **Practice address:** 407 N HERMAN ST, GOLDSBORO, NC 27530-3816
- **Practice address phone:** (919) 583-9788
- **Practice address fax:** (919) 583-9790
- **Mailing address:** 407 N HERMAN ST, GOLDSBORO, NC 27530-3816
- **Mailing address phone:** (919) 583-9788
- **Mailing address fax:** (919) 583-9790

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213E00000X | Podiatrist | 357 | NC | Yes |

## Other

- **Enumeration date:** 11/02/2007
- **Last updated:** 03/07/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0818H | BCBS | NC |
| 05 | — | 890818H | — | NC |