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Organization
JACKSONVILLE CHILDREN'S AND MULTISPECIALTY CLINIC, PA
Active
Organization
JACKSONVILLE CHILDREN'S AND MULTISPECIALTY CLINIC, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ISHWAR HAKUMAL GOPICHAND MD (CMO)
(919) 589-1240
Entity
Organization
Contact information
Practice address
118 MEMORIAL DR, JACKSONVILLE, NC 28546-6328
(910) 353-0581
(910) 353-1351
Mailing address
PO BOX 986513, DEPARTMENT 100, BOSTON, MA 02298-6513
(910) 219-8326
(910) 939-4269
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
—
NULL
207KA0200X
Allergy Physician
—
—
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
207RG0100X
Gastroenterology Physician
—
NULL
207RG0100X
Gastroenterology Physician
—
—
208000000X
Pediatrics Physician
—
NULL
208000000X
Pediatrics Physician
—
—
2080N0001X
Neonatal-Perinatal Medicine Physician
—
NULL
2080N0001X
Neonatal-Perinatal Medicine Physician
—
—
2080P0008X
Pediatric Neurodevelopmental Disabilities Physician
—
NULL
2080P0008X
Pediatric Neurodevelopmental Disabilities Physician
—
—
2080P0202X
Pediatric Cardiology Physician
—
NULL
2080P0202X
Pediatric Cardiology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1164519070
—
NC
Enumeration date
10/10/2006
Last updated
01/19/2026
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