Organization
CLINIC ON THE CORNER, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACI MORRIS CREDENTIALING SPECIA (PRACRICE MANAGER)
(702) 326-6749
Entity
Organization
Contact information
Practice address
3918 BISHOP RD, ROCKY MOUNT, NC 27804-2780
(252) 299-0057
(252) 673-2518
Mailing address
3918 BISHOP RD, ROCKY MOUNT, NC 27804
(252) 299-0057
(252) 673-2518
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Enumeration date
09/27/2022
Last updated
10/17/2022
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