Organization
COASTAL CAROLINA NEUROPSYCHIATRIC CENTER, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARLA MIKHAIL (PRACTICE ADMINISTRATOR)
(910) 938-1114
Entity
Organization
Contact information
Practice address
200 TARPON TRAIL, JACKSONVILLE, NC 28546-5266
(910) 938-1114
(910) 938-1118
Mailing address
200 TARPON TRAIL, JACKSONVILLE, NC 28546-5266
(910) 938-1114
(910) 938-1118
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
103T00000X
Psychologist
—
—
207Q00000X
Family Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
2084N0400X
Neurology Physician
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
08/17/2006
Last updated
08/05/2020
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