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Organization

JAGDISH LAL MD PA

Active
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Organization

JAGDISH LAL MD PA

Active
Other names
Rayconda Internal Medicine
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JAGDISH LAL MD (OWNER PHYSICIAN)
(910) 864-7933
Entity
Organization

Contact information

Practice address
6977 NEXUS COURT, SUITE 101, FAYETTEVILLE, NC 28304-2651
(910) 864-7933
(910) 864-3180
Mailing address
PO BOX 25217, FAYETTEVILLE, NC 28314
(910) 864-7933
(910) 864-3180

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
9900578
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0438753
UHC
01
084806830
TRICARE
01
12136
BCBS
05
8912136
NC
Enumeration date
07/16/2006
Last updated
06/28/2010
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