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Individual

MR. JACK RICHARD CAHN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
214 DOCTORS ST, SPARTA, NC 28675-9247
(336) 372-5606
(336) 372-6211
Mailing address
214 DOCTORS ST, SPARTA, NC 28675
(336) 372-5606
(336) 372-6211

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
19788
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0107814
UNITIED HEALTHCARE
01
20644
NCBCBS
01
21734
MEDCOST
01
5001
PARTNERS CHOICE
05
5603595
VA
05
8920644
NC
Enumeration date
02/06/2006
Last updated
12/12/2007
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