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Organization

LAURA JACIMORE, PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. LAURA LYN JACIMORE M.D. (PRESIDENT)
(919) 971-4976
Entity
Organization

Contact information

Practice address
2450 CURTIS ELLIS DR, ROCKY MOUNT, NC 27804-2237
(252) 443-8947
(252) 451-3090
Mailing address
105 MONABREEZE WAY, GARNER, NC 27529-4369
(919) 773-3735

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
891358H
NC
Enumeration date
12/19/2007
Last updated
08/16/2021
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