Individual
CEASAR R TRIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2420 HENDERSON DR, JACKSONVILLE, NC 28546
(910) 937-0008
(910) 937-0098
Mailing address
2420 HENDERSON DR, JACKSONVILLE, NC 28546-5254
(910) 937-0008
(910) 937-0098
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-07662
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0010-07662
NC MEDICAL LICENSE
NC
Enumeration date
10/27/2017
Last updated
03/07/2023
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