Provider Demographics
NPI:1588840417
Name:FELICIA D. HUSSEY, M.D., P.A.
Entity Type:Organization
Organization Name:FELICIA D. HUSSEY, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FELICIA
Authorized Official - Middle Name:D
Authorized Official - Last Name:HUSSEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-778-7934
Mailing Address - Street 1:327 N SPENCE AVE
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27534-4347
Mailing Address - Country:US
Mailing Address - Phone:919-778-7934
Mailing Address - Fax:919-778-7683
Practice Address - Street 1:327 N SPENCE AVE
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-4347
Practice Address - Country:US
Practice Address - Phone:919-778-7934
Practice Address - Fax:919-778-7683
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-10
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9701412207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891228PMedicaid
NC1228POtherBCBS
NC891228PMedicaid