Organization
JACKSONVILLE ORTHOPEDIC CLINIC, P.A.
Active
Organization
JACKSONVILLE ORTHOPEDIC CLINIC, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NOEL B ROGERS M.D. (PRESIDENT)
(910) 353-4500
Entity
Organization
Contact information
Practice address
128 MEMORIAL DR, JACKSONVILLE, NC 28546-6328
(910) 353-4500
(910) 353-5610
Mailing address
128 MEMORIAL DR, JACKSONVILLE, NC 28546-6328
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01899
BLUE CROS BLUE SHIELD
NC
05
—
8901899
—
NC
Enumeration date
01/19/2007
Last updated
03/04/2008
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