# LUMBER RIVER FAMILY PRACTICE PLLC

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

## Provider details

- **NPI number:** 1710732458
- **Authorized official:** DR. JOSEPH ROBERTS MD (MEDICAL DIRECTOR)
- **Authorized official phone:** (910) 618-7139

## Contact information

- **Practice address:** 105 FARM BROOK DR, LUMBERTON, NC 28358-2179
- **Practice address phone:** (910) 738-7789
- **Mailing address:** 105 FARM BROOK DR, LUMBERTON, NC 28358-2179

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 261QP2300X | Primary Care Clinic/Center | — | NULL | Yes |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |
| 363LP2300X | Primary Care Nurse Practitioner | — | NULL | — |
| 363LP2300X | Primary Care Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 04/17/2024
- **Last updated:** 04/17/2024