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Organization

RUDOLPH I MINTZ JR

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RUDOLPH I. MINTZ JR. M.D. (OWNER/OPERATOR)
(252) 527-5500
Entity
Organization

Contact information

Practice address
400 GLENWOOD AVE, SUITE 11, KINSTON, NC 28501-3851
(252) 527-5500
(252) 527-4875
Mailing address
400 GLENWOOD AVE, SUITE 11, KINSTON, NC 28501-3851
(252) 527-5500
(252) 527-4875

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
15536
NC

Other

Enumeration date
08/31/2007
Last updated
10/18/2010
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