Provider Demographics
NPI:1982724050
Name:FORD, JOHN ERSKINE (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ERSKINE
Last Name:FORD
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10354
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27532-0354
Mailing Address - Country:US
Mailing Address - Phone:919-735-8887
Mailing Address - Fax:919-735-8871
Practice Address - Street 1:2307 NORWOOD AVE
Practice Address - Street 2:SUITE C
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-1601
Practice Address - Country:US
Practice Address - Phone:919-735-8887
Practice Address - Fax:919-735-8871
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0715103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist