Provider Demographics
NPI:1437112968
Name:FLOYD DEEN, JR., M.D., P.A.
Entity Type:Organization
Organization Name:FLOYD DEEN, JR., M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CARPENTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-694-5164
Mailing Address - Street 1:402 MORVEN RD
Mailing Address - Street 2:
Mailing Address - City:WADESBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28170-2743
Mailing Address - Country:US
Mailing Address - Phone:704-694-5164
Mailing Address - Fax:704-695-1184
Practice Address - Street 1:402 MORVEN RD
Practice Address - Street 2:
Practice Address - City:WADESBORO
Practice Address - State:NC
Practice Address - Zip Code:28170-2743
Practice Address - Country:US
Practice Address - Phone:704-694-5164
Practice Address - Fax:704-695-1184
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC39033261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890297YMedicaid
NC0297YOtherBCBS OF NC
NC2325501Medicare ID - Type Unspecified