Provider Demographics
NPI:1437236338
Name:ONSLOW HEALTH ASSOCIATES PLLC
Entity Type:Organization
Organization Name:ONSLOW HEALTH ASSOCIATES PLLC
Other - Org Name:PEDIATRIC URGENT CARE PLLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:910-340-7773
Mailing Address - Street 1:504 SARAH COURT
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28540
Mailing Address - Country:US
Mailing Address - Phone:910-347-7773
Mailing Address - Fax:910-347-7792
Practice Address - Street 1:1201 COUNTRY CLUB ROAD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546
Practice Address - Country:US
Practice Address - Phone:910-347-7773
Practice Address - Fax:910-347-7792
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2018-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC23340208000000X
208000000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
B6631OtherMEDCOST
D16P8OtherBCBS
NC89106P8Medicaid
=========001OtherTRICARE HUMMANNA