Provider Demographics
NPI:1508880014
Name:FIRST FLIGHT ORTHOPAEDICS & SPORTS MEDICINE PA
Entity Type:Organization
Organization Name:FIRST FLIGHT ORTHOPAEDICS & SPORTS MEDICINE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:MCALLISTER
Authorized Official - Last Name:CHASE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:252-261-9940
Mailing Address - Street 1:3102 N CROATAN HWY
Mailing Address - Street 2:
Mailing Address - City:KILL DEVIL HILLS
Mailing Address - State:NC
Mailing Address - Zip Code:27948-9200
Mailing Address - Country:US
Mailing Address - Phone:252-261-9940
Mailing Address - Fax:252-261-9087
Practice Address - Street 1:3102 N CROATAN HWY
Practice Address - Street 2:
Practice Address - City:KILL DEVIL HILLS
Practice Address - State:NC
Practice Address - Zip Code:27948-9200
Practice Address - Country:US
Practice Address - Phone:252-261-9940
Practice Address - Fax:252-261-9087
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-27
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89011X0Medicaid
NC011X0OtherBCBS
DB4314OtherRR MEDICARE
2331597Medicare ID - Type Unspecified
3995540001Medicare NSC