Provider Demographics
NPI:1093065229
Name:MCPC-6, LLC
Entity Type:Organization
Organization Name:MCPC-6, LLC
Other - Org Name:FIRSTHEALTH BACK AND NECK PAIN CENTER-HOKE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:S
Authorized Official - Last Name:DEJACO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-715-1913
Mailing Address - Street 1:4565 FAYETTEVILLE RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:RAEFORD
Mailing Address - State:NC
Mailing Address - Zip Code:28376-7998
Mailing Address - Country:US
Mailing Address - Phone:910-878-5150
Mailing Address - Fax:910-878-5190
Practice Address - Street 1:4565 FAYETTEVILLE RD
Practice Address - Street 2:SUITE B
Practice Address - City:RAEFORD
Practice Address - State:NC
Practice Address - Zip Code:28376-7998
Practice Address - Country:US
Practice Address - Phone:910-878-5150
Practice Address - Fax:910-878-5190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-14
Last Update Date:2012-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty