Organization
WILKES RADIOLOGY, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID FACTOR M.D. (PRESIDENT)
(336) 846-0722
Entity
Organization
Contact information
Practice address
200 HOSPITAL AVE, RADIOLOGY DEPARTMENT, JEFFERSON, NC 28640-9244
(336) 846-0722
Mailing address
PO BOX 32364, KNOXVILLE, TN 37930-2364
(800) 343-2599
(865) 531-2722
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7901295
—
NC
01
—
CG2821
RR MEDICARE
—
Enumeration date
11/29/2005
Last updated
09/11/2012
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