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Organization
LENOIR FAMILY MEDICINE, PA
Active
Organization
LENOIR FAMILY MEDICINE, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LADDIE MOORE CRISP JR. M.D. (PRESIDENT)
(252) 527-4146
Entity
Organization
Contact information
Practice address
107 AIRPORT RD, KINSTON, NC 28501-1603
(252) 527-4146
(252) 527-5697
Mailing address
107 AIRPORT RD, KINSTON, NC 28501-1603
(252) 527-4146
(252) 527-5697
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0164U
BCBS/NC
NC
05
—
89013RG
—
NC
Enumeration date
09/26/2006
Last updated
07/13/2010
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