Organization
SOZO HEALTH PAVILION, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PHYLLIS AYCOCK WILLIAMS R.N. (MANAGER)
(910) 455-7110
Entity
Organization
Contact information
Practice address
615 COLLEGE ST, JACKSONVILLE, NC 28540-5310
(910) 455-7110
(910) 455-7938
Mailing address
PO BOX 7105, JACKSONVILLE, NC 28540-2105
(910) 455-7110
(910) 455-7938
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
28713
NC
101YP1600X
Pastoral Counselor
28713
NC
163WG0000X
General Practice Registered Nurse
082155
NC
207Q00000X
Family Medicine Physician
28713
NC
207QA0401X
Addiction Medicine (Family Medicine) Physician
28713
NC
207QA0505X
Adult Medicine Physician
Primary
28713
NC
207VG0400X
Gynecology Physician
28713
NC
2083P0901X
Public Health & General Preventive Medicine Physician
28713
NC
208D00000X
General Practice Physician
28713
NC
251S00000X
Community/Behavioral Health Agency
28713
NC
Other
Enumeration date
05/17/2006
Last updated
02/28/2011
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