Organization
FAILLACE GENERAL SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEON F FAILLACE MD (PRESIDENT)
(910) 485-6277
Entity
Organization
Contact information
Practice address
2041 VALLEYGATE DR, SUITE 202-A, FAYETTEVILLE, NC 28304-3688
(910) 485-6277
Mailing address
PO BOX 61811, DURHAM, NC 27715-1811
(919) 544-6318
(919) 544-6336
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7931041
—
NC
Enumeration date
04/28/2006
Last updated
08/22/2020
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