# BREEZEWOOD FAMILY HEALTHCARE, PA

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

## Provider details

- **NPI number:** 1356404453
- **Authorized official:** MR. MICHAEL J. JANSEN (ADMINISTRATOR)
- **Authorized official phone:** (910) 485-0700

## Contact information

- **Practice address:** 200 FORSYTHE ST, FAYETTEVILLE, NC 28303-5426
- **Practice address phone:** (910) 485-0700
- **Practice address fax:** (910) 483-9572
- **Mailing address:** PO BOX 87448, FAYETTEVILLE, NC 28304-7448
- **Mailing address phone:** (910) 485-0700
- **Mailing address fax:** (910) 483-9572

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 116914 | NC | Yes |

## Other

- **Enumeration date:** 12/19/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 017EM | BCBSNC GROUP NUMBER | NC |