Provider Demographics
NPI:1346370061
Name:JACKSONVILLE OBSTETRICS, GYNECOLOGY & INFERTILITY, P.A.
Entity Type:Organization
Organization Name:JACKSONVILLE OBSTETRICS, GYNECOLOGY & INFERTILITY, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WESLEY
Authorized Official - Middle Name:F
Authorized Official - Last Name:HAMBRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:910-577-4255
Mailing Address - Street 1:291 HUFF DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28546-7370
Mailing Address - Country:US
Mailing Address - Phone:910-577-4255
Mailing Address - Fax:910-577-0074
Practice Address - Street 1:291 HUFF DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-7370
Practice Address - Country:US
Practice Address - Phone:910-577-4255
Practice Address - Fax:910-577-0074
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2011-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC30357174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty