Provider Demographics
NPI:1346475571
Name:REX PHYSICIANS, LLC
Entity type:Organization
Organization Name:REX PHYSICIANS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:BERNADETTE
Authorized Official - Middle Name:M
Authorized Official - Last Name:SPONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-784-3245
Mailing Address - Street 1:1101 DRESSER CT
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-7327
Mailing Address - Country:US
Mailing Address - Phone:919-876-2010
Mailing Address - Fax:919-954-0555
Practice Address - Street 1:1101 DRESSER CT
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-7327
Practice Address - Country:US
Practice Address - Phone:919-876-2010
Practice Address - Fax:919-954-0555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-18
Last Update Date:2009-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2347365Medicare PIN