Organization
TAKEY CRIST MD PA
Active
Other names
Crist Clinic for Women
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TAKEY CRIST MD (OWNER PRESIDENT)
(910) 353-2115
Entity
Organization
Contact information
Practice address
250 MEMORIAL DR, JACKSONVILLE, NC 28546-6332
(910) 353-2115
(910) 355-2422
Mailing address
250 MEMORIAL DR, JACKSONVILLE, NC 28546-6332
(910) 353-2115
(910) 355-2422
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
40776
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01370
BLUE CROSS BLUE SHIELD
NC
05
—
8901370
—
NC
Enumeration date
01/26/2006
Last updated
07/17/2013
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