# JEROME V PONDER MD PC

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

## Provider details

- **NPI number:** 1598775025
- **Authorized official:** DR. JEROME V PONDER M.D. (OWNER)
- **Authorized official phone:** (910) 480-4880

## Contact information

- **Practice address:** 413 OWEN DR, SUITE 101, FAYETTEVILLE, NC 28304-3489
- **Practice address phone:** (910) 480-4880
- **Practice address fax:** (910) 488-4856
- **Mailing address:** 413 OWEN DR, SUITE 101, FAYETTEVILLE, NC 28304-3489
- **Mailing address phone:** (910) 480-4880
- **Mailing address fax:** (910) 488-4856

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/08/2006
- **Last updated:** 12/12/2011