Provider Demographics
NPI:1295886166
Name:DRAUGHN, ROLAND C (MD)
Entity type:Individual
Prefix:DR
First Name:ROLAND
Middle Name:C
Last Name:DRAUGHN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:603 E COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:WARSAW
Mailing Address - State:NC
Mailing Address - Zip Code:28398-2104
Mailing Address - Country:US
Mailing Address - Phone:910-293-3900
Mailing Address - Fax:910-293-6702
Practice Address - Street 1:603 E COLLEGE ST
Practice Address - Street 2:
Practice Address - City:WARSAW
Practice Address - State:NC
Practice Address - Zip Code:28398-2104
Practice Address - Country:US
Practice Address - Phone:910-293-3900
Practice Address - Fax:910-293-6702
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2013-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC37821207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8929167Medicaid
NCE10606Medicare UPIN