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FAMILY TREE OB GYN PA NPI 1730276890


NPI Information

NPI: 1730276890
Provider Name: FAMILY TREE OB GYN, PA
Classification: Specialist - 174400000X
Entity Type: Organization
Address:
520 MAPLE AVE
SUITE C
REIDSVILLE, NC
ZIP 27320
Phone: (336) 342-6063
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FAMILY TREE OB GYN, PA is a specialist in Reidsville, NC. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. FAMILY TREE OB GYN, PA NPI is 1730276890. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

520 MAPLE AVE
SUITE C
REIDSVILLE, NC
ZIP 27320-652
Phone: (336) 342-6063
Fax: (336) 342-7847

The provider's authorized official is John Vaughn Ferguson .
The authorized official title is Md Owner and has the following contact phone number (336) 342-6063.

The enumeration date for this NPI number is 10/9/2006 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialist26070NORTH CAROLINAYes
2207V00000XObstetrics & GynecologyX
3363LA2200XNurse PractitionerAdult HealthX
4363LG0600XNurse PractitionerGerontologyX
5367A00000XAdvanced Practice MidwifeX

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
189012KHMEDICAIDNORTH CAROLINA
2012KHOTHERNORTH CAROLINABCBS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.