# DEACON MED PA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Optimus Medical Center at Randleman
- **Organization subpart:** No

## Provider details

- **NPI number:** 1881998748
- **Authorized official:** DR. JEROME I DAVIS MD (MEDICAL DIRECTOR)
- **Authorized official phone:** (336) 545-1515

## Contact information

- **Practice address:** 702 S MAIN ST, RANDLEMAN, NC 27317-2102
- **Practice address phone:** (336) 545-1515
- **Practice address fax:** (336) 545-4505
- **Mailing address:** 702 S MAIN ST, RANDLEMAN, NC 27317-2102
- **Mailing address phone:** (336) 545-1515
- **Mailing address fax:** (336) 545-4505

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2300X | Primary Care Clinic/Center | — | NC | Yes |

## Other

- **Enumeration date:** 01/06/2011
- **Last updated:** 01/06/2011