Organization
OWEN PARK PEDIATRICS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL O ADHOLLA MD (OWNER)
(910) 860-3500
Entity
Organization
Contact information
Practice address
1520 OWEN PARK LN, FAYETTEVILLE, NC 28304-3454
(910) 860-3500
(910) 485-3507
Mailing address
1520 OWEN PARK LN, FAYETTEVILLE, NC 28304-3454
(910) 860-3500
(910) 485-3507
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8911931
—
NC
Enumeration date
07/14/2008
Last updated
07/14/2008
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