Organization
JOHN A AZZATO MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEAN PHILLIPS (OFFICE MANAGER)
(910) 805-5578
Entity
Organization
Contact information
Practice address
1513 N HOWE ST, SUITE 4, SOUTHPORT, NC 28461-2769
(910) 805-5578
Mailing address
PO BOX 11505, SOUTHPORT, NC 28461-1505
(910) 805-5578
Taxonomy
Speciality
Code
Description
License number
State
202C00000X
Independent Medical Examiner Physician
20698
NC
207X00000X
Orthopaedic Surgery Physician
Primary
20698
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8912440
—
NC
Enumeration date
05/29/2012
Last updated
01/16/2013
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