Individual
DAVID KISHBAUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2109 VALLEYGATE DR, SUITE 201, FAYETTEVILLE, NC 28304-3571
(910) 486-8880
(910) 486-8886
Mailing address
PO BOX 41054, FAYETTEVILLE, NC 28309-1054
(910) 486-8880
(910) 486-8886
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
9500379
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8949528
—
NC
Enumeration date
04/10/2006
Last updated
02/11/2010
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