Individual
MR. ALLEN JAMES SOURS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2100 STANTONSBURG RD, GREENVILLE, NC 27834-2818
(252) 847-1055
Mailing address
2100 STANTONSBURG RD, GREENVILLE, NC 27834-2818
(252) 847-1055
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
103459
NC
363A00000X
Physician Assistant
Primary
103459
NC
363AM0700X
Medical Physician Assistant
103459
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
970026341
RAILROAD MEDICARE
NC
Enumeration date
02/07/2006
Last updated
03/10/2026
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