1780994376 NPI number — KARIKA PARTILIA WATKINS-HILL PA

Table of content: KARIKA PARTILIA WATKINS-HILL PA (NPI 1780994376)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780994376 NPI number — KARIKA PARTILIA WATKINS-HILL PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WATKINS-HILL
Provider First Name:
KARIKA
Provider Middle Name:
PARTILIA
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1780994376
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/27/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
308 DOLPHIN DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
JACKSONVILLE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28546-5266
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
910-346-2273
Provider Business Mailing Address Fax Number:
910-346-1907

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1515 SUNSET AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLINTON
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28328-3827
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-592-4000
Provider Business Practice Location Address Fax Number:
910-592-4007
Provider Enumeration Date:
10/15/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363A00000X , with the licence number:  C0003777 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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