Organization

Jacksonville Children'S And Multispecialty Clinic, Pa

Family Medicine Physician in Jacksonville, NC(View on Map)

Legal Business Name

Jacksonville Children'S And Multispecialty Clinic, Pa

NPI Number

1164519070

NPI Type

Organization

Enumeration Date

10/10/2006

Contact
Information

Purpose

Mailing
Location

Address

PO BOX 986513
118 MEMORIAL DR

City

Boston
Jacksonville

State

MA
NC

Postal Code

02298-6513
28546-6328

Country

US
US

Telephone Number

(910) 219-8326
(910) 353-0581

Authorized Official

Name

Dr. Madhur Mittal

Title or Position

PRESIDENT

Telephone Number

(910) 353-0581

Identifiers

Identifier

1164519070

Identifier State

NC

Identifier Issuer

Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 09/12/2024

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