Individual
JOHN L. ROUSE III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
403 FAIRVIEW ST, CLINTON, NC 28328-2311
(910) 590-0601
(910) 592-0815
Mailing address
403 FAIRVIEW ST, CLINTON, NC 28328-2311
(910) 590-0601
(910) 592-0815
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
00-18709
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0138820
UNITED HEALTHCARE
NC
01
—
30129
MEDCOST
NC
01
—
4415804
AETNA
NC
01
—
73483
NC BLUE CROSS BLUE SHIELD
NC
05
—
8973483
—
NC
Enumeration date
06/29/2006
Last updated
10/17/2007
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