Organization · Type 2 NPI

Lifesource of North Carolina

General Practice Physician · Cheyenne, WY

NPI number 1386144418 Active

Practice location

1208 E Pershing Blvd
Cheyenne, WY 82001-3230

Call (910) 742-9243 Map

Fax (888) 746-1787

Mailing address

PO Box 538622
Atlanta, GA 30353-8622

Specialties and licenses

TaxonomyCodeLicense
Clinical Psychologist 103TC0700XNone listed
Clinical Social Worker 1041C0700XNone listed
Family Medicine Physician 207Q00000XNone listed
Psychiatry Physician 2084P0800XNone listed
General Practice Physician Primary 208D00000XNone listed
Physician Assistant 363A00000XNone listed
Nurse Practitioner 363L00000XNone listed

General Practice Physician: A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

3 other providers at this address

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About NPI 1386144418

Lifesource of North Carolina's National Provider Identifier is 1386144418, issued on Feb 15, 2018. The primary taxonomy on file is General Practice Physician (208D00000X), and the practice location is in Cheyenne, WY. The record was last updated on Mar 25, 2021.