Organization
FAISON MEDICAL CARE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALPHONZA FAISON JR. FNP (OWNER)
(336) 622-6000
Entity
Organization
Contact information
Practice address
5201 W MARKET ST STE 108, GREENSBORO, NC 27409-3432
(336) 622-6000
Mailing address
5201 W MARKET ST STE 108, GREENSBORO, NC 27409-3432
(336) 622-6000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
208VP0000X
Pain Medicine Physician
—
—
363L00000X
Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1093359366
—
NC
Enumeration date
10/30/2019
Last updated
09/22/2020
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