Organization
EAR,NOSE&THROAT HEAD,NECK&SINUS SURGERY,PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANTHONY W JACKSON SR. MD (PRESIDENT OF CORPORATION)
(252) 337-7409
Entity
Organization
Contact information
Practice address
105 MEDICAL DR, ELIZABETH CITY, NC 27909-3361
(252) 337-7409
(252) 337-7410
Mailing address
105 MEDICAL DR, ELIZABETH CITY, NC 27909-3361
(252) 337-7409
(252) 337-7410
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
09/25/2007
Last updated
10/20/2008
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