Provider Demographics
NPI:1841361649
Name:CREECH, JOSEPH JAN (DO)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:JAN
Last Name:CREECH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4929 OLD BEULAH RD
Mailing Address - Street 2:
Mailing Address - City:SELMA
Mailing Address - State:NC
Mailing Address - Zip Code:27576-7483
Mailing Address - Country:US
Mailing Address - Phone:919-284-3377
Mailing Address - Fax:
Practice Address - Street 1:4929 OLD BEULAH RD
Practice Address - Street 2:
Practice Address - City:SELMA
Practice Address - State:NC
Practice Address - Zip Code:27576-7483
Practice Address - Country:US
Practice Address - Phone:919-284-3377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC24111207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine