Individual
DR. JUSTIN ALAN BACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
210 MEDICAL PAVILION DR, RAEFORD, NC 28376-9111
(910) 904-8000
Mailing address
9040 FITZSIMMONS DR, JOINT BASE LEWIS MCCHORD, WA 98431-1000
(253) 968-2997
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2018-02158
NC
Other
Enumeration date
03/31/2015
Last updated
08/14/2019
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