Provider Demographics
NPI:1669687851
Name:NORTHAMPTON FAMILY PRACTICE, PC
Entity Type:Organization
Organization Name:NORTHAMPTON FAMILY PRACTICE, PC
Other - Org Name:BOYKINS FAMILY PRACTICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:FRANCIS
Authorized Official - Middle Name:MARVIN
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:252-585-1134
Mailing Address - Street 1:PO BOX 348
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:NC
Mailing Address - Zip Code:27820-0348
Mailing Address - Country:US
Mailing Address - Phone:252-585-1134
Mailing Address - Fax:252-585-0274
Practice Address - Street 1:111 E MAIN ST
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:NC
Practice Address - Zip Code:27820-0348
Practice Address - Country:US
Practice Address - Phone:252-585-1134
Practice Address - Fax:252-585-0274
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTHAMPTON FAMILY PRACTICE, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-11
Last Update Date:2015-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9900696261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC013N7OtherBLUE CROSS BLUE SHIELD
NC89013N7Medicaid
NC2328764Medicare PIN
VAC10307Medicare PIN
NCH00800Medicare UPIN