Organization
JACKSONVILLE CHILDREN'S AND MULTISPECIALTY CLINIC, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ISHWAR HAKUMAL GOPICHAND MD (CMO)
(919) 589-1240
Entity
Organization
Contact information
Practice address
118 MEMORIAL DR, JACKSONVILLE, NC 28546-6328
(910) 353-0581
(910) 353-1351
Mailing address
PO BOX 986513, DEPARTMENT 100, BOSTON, MA 02298-6513
(910) 219-8326
(910) 939-4269
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207RG0100X
Gastroenterology Physician
—
—
208000000X
Pediatrics Physician
—
—
2080N0001X
Neonatal-Perinatal Medicine Physician
—
—
2080P0008X
Pediatric Neurodevelopmental Disabilities Physician
—
—
2080P0202X
Pediatric Cardiology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1164519070
—
NC
Enumeration date
10/10/2006
Last updated
01/19/2026
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