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Organization

MOUNT JEFFERSON FAMILY MEDICINE, P.A.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RITA D RICHARDSON (CORPORATE SECRETARY)
(336) 846-7433
Entity
Organization

Contact information

Practice address
200 HOSPITAL AVE, SUITE 3, JEFFERSON, NC 28640-9244
(336) 846-7433
(336) 846-7878
Mailing address
PO BOX 369, JEFFERSON, NC 28640-0369
(336) 846-7433
(336) 846-7878

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0173A
BCBSNC
NC
05
790173A
NC
Enumeration date
07/06/2006
Last updated
12/07/2015
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