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Organization
CYPRESS PATHOLOGY PA
Active
Organization
CYPRESS PATHOLOGY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. METT BAGLEY AUSLEY JR. MD (PRESIDENT)
(910) 642-1715
Entity
Organization
Contact information
Practice address
500 JEFFERSON ST, WHITEVILLE, NC 28472-3634
(910) 642-1715
Mailing address
PO BOX 20169, ROANOKE, VA 24018-0506
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
38004
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0209J
BCBS #
NC
05
—
890209J
—
NC
01
—
DF2081
RAILROAD MEDICARE
—
Enumeration date
02/27/2006
Last updated
05/14/2020
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