Organization
WACCAMAW PRIMARY CARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY ALAN CLARKE PA (OWNER)
(910) 642-2230
Entity
Organization
Contact information
Practice address
619 JEFFERSON ST, WHITEVILLE, NC 28472-3707
(910) 642-2230
Mailing address
PO BOX 790, WHITEVILLE, NC 28472-0790
(910) 641-0400
(910) 642-5929
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
101710
NC
Other
Enumeration date
08/12/2010
Last updated
08/12/2010
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