Organization
EAGLE PHYSICIANS AND ASSOCIATES PA
Active
Parent organization
EAGLE PHYSICIANS AND ASSOCIATES PA
Other names
Eagle Pediatrics
Organization subpart
Yes
Provider details
NPI number
Legal business name
EAGLE PHYSICIANS AND ASSOCIATES PA
Authorized official
TERRI S. JONES (DIRECTOR, EAGLE BUSINESS SERVICES)
(336) 268-3201
Entity
Organization
Contact information
Practice address
5500 W FRIENDLY AVE STE 200, GREENSBORO, NC 27410-4368
(336) 373-1996
(336) 482-2320
Mailing address
PO BOX 14883, GREENSBORO, NC 27415-4883
(336) 482-2300
(336) 482-2320
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
208000000X
Pediatrics Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
012XV
BCBS OF NC
NC
05
—
89012XV
—
NC
Enumeration date
11/08/2006
Last updated
06/10/2020
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