# BUCKHEAD EXPRESS CLINIC PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255661302
- **Authorized official:** AGODI U NWOSU MD (PRESIDENT)
- **Authorized official phone:** (910) 483-1493

## Contact information

- **Practice address:** 3613A RAEFORD RD, FAYETTEVILLE, NC 28304-2113
- **Practice address phone:** (910) 483-1493
- **Practice address fax:** (910) 920-4212
- **Mailing address:** 3613A RAEFORD RD, FAYETTEVILLE, NC 28304-2113
- **Mailing address phone:** (910) 483-1493
- **Mailing address fax:** (910) 920-4212

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/12/2010
- **Last updated:** 02/09/2010