Organization
CLEMMONS PSYCHIATRIC ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FLORENCE E DAVIS M.D. (OWNER)
(336) 778-0506
Entity
Organization
Contact information
Practice address
2511 NEUDORF RD, SUITE B, CLEMMONS, NC 27012-8993
(336) 778-0506
Mailing address
2511 NEUDORF RD, SUITE B, CLEMMONS, NC 27012-8993
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
27584
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1538326673
BLUE CROSS BLUE SHIELD
NC
Enumeration date
01/11/2016
Last updated
01/11/2016
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