Provider Demographics
NPI:1447406608
Name:NORTH CAROLINA INPATIENT MEDICINE ASSOCIATES PLLC
Entity Type:Organization
Organization Name:NORTH CAROLINA INPATIENT MEDICINE ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP CLINICAL SERVICES
Authorized Official - Prefix:DR
Authorized Official - First Name:TALBOT
Authorized Official - Middle Name:G
Authorized Official - Last Name:MCCORMICK
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:678-397-0060
Mailing Address - Street 1:PO BOX 52007
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30355-0007
Mailing Address - Country:US
Mailing Address - Phone:678-397-0060
Mailing Address - Fax:678-397-0065
Practice Address - Street 1:317 WESTERN BLVD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-6338
Practice Address - Country:US
Practice Address - Phone:910-577-2360
Practice Address - Fax:910-577-2433
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EAGLE HOSPITAL PHYSICIANS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-08-07
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5903385Medicaid