Provider Demographics
NPI:1376712802
Name:WAYNE T. JARMAN, MD PA
Entity Type:Organization
Organization Name:WAYNE T. JARMAN, MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:T
Authorized Official - Last Name:JARMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:252-527-9332
Mailing Address - Street 1:703D ROSANNE DR
Mailing Address - Street 2:
Mailing Address - City:KINSTON
Mailing Address - State:NC
Mailing Address - Zip Code:28504-1551
Mailing Address - Country:US
Mailing Address - Phone:252-527-9332
Mailing Address - Fax:252-527-9234
Practice Address - Street 1:703D ROSANNE DR
Practice Address - Street 2:
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28504-1551
Practice Address - Country:US
Practice Address - Phone:252-527-9332
Practice Address - Fax:252-527-9234
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-28
Last Update Date:2008-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC19756174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5909149Medicaid
NC5909149Medicaid