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Individual

DR. JEAN ELIZABETH AYCOCK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
867 WASHINGTON ST, RALEIGH, NC 27605-1255
(919) 833-5869
(919) 833-5859
Mailing address
867 WASHINGTON ST, RALEIGH, NC 27605-1255
(919) 833-5869
(919) 833-5859

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
30118
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
12403
BCBS
NC
01
30118
STATE LICENSE NUMBER
NC
Enumeration date
06/03/2007
Last updated
07/08/2007
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