Provider Demographics
NPI:1659335461
Name:FAMILY AND COMMUNITY MEDICINE OF ASHEBORO P.A.
Entity Type:Organization
Organization Name:FAMILY AND COMMUNITY MEDICINE OF ASHEBORO P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:M
Authorized Official - Last Name:WHYTE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:336-672-3200
Mailing Address - Street 1:350 N COX STREET
Mailing Address - Street 2:SUITE #20
Mailing Address - City:ASHEBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27203-5566
Mailing Address - Country:US
Mailing Address - Phone:336-672-2044
Mailing Address - Fax:336-629-7349
Practice Address - Street 1:350 N COX ST
Practice Address - Street 2:SUITE #20
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27203-5566
Practice Address - Country:US
Practice Address - Phone:336-672-2044
Practice Address - Fax:336-629-7349
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC30518207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC012FWOtherBCBS GROUP NUMBER
NC89012FWMedicaid
NC89012FWMedicaid
NC89012FWMedicaid