Organization
KURT G VERNON MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KURT VERNON MD (MEDICAL DIRECTOR)
(919) 577-0085
Entity
Organization
Contact information
Practice address
1004 PROCURE DR, FUQUAY VARINA, NC 27526-2620
(919) 577-0085
(919) 577-0013
Mailing address
1004 PROCURE DR, FUQUAY VARINA, NC 27526-2620
(919) 577-0085
(919) 577-0013
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
9501139
NC
261QE0800X
Endoscopy Clinic/Center
Primary
9501139
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
84580
MEDCOST
NC
01
—
85016
BLUE CROSS BLUE SHEILD
NC
05
—
8985016
—
NC
Enumeration date
05/22/2013
Last updated
07/09/2013
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