Organization
EAGLE PHYSICIANS AND ASSOCIATES PA
Active
Parent organization
EAGLE PHYSICIANS AND ASSOCIATES PA
Other names
Eagle Internal Medicine at Tannenbaum
Organization subpart
Yes
Provider details
NPI number
Legal business name
EAGLE PHYSICIANS AND ASSOCIATES PA
Authorized official
TERRI S. JONES (DIRECTOR, EAGLE BUSINESS SERVICES)
(336) 268-3201
Entity
Organization
Contact information
Practice address
301 E WENDOVER AVE, SUITE 200, GREENSBORO, NC 27401-1230
(336) 274-3241
(336) 268-4444
Mailing address
PO BOX 14883, GREENSBORO, NC 27415-4883
(336) 274-3241
(336) 268-4444
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
207RG0100X
Gastroenterology Physician
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
207RR0500X
Rheumatology Physician
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0134T
BCBS OF NC
NC
05
—
890134T
—
NC
Enumeration date
11/13/2006
Last updated
09/24/2015
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