Jack Lee Boone in Hertford - General Practice

Jack Lee Boone - NPI 1619907474

Jack Lee Boone is a General Practice in Hertford, North Carolina. Jack Lee Boone practices all healthcare services and medical treatments related to General Practice. The NPI Number for Jack Lee Boone is 1619907474. The last update date is 2007-07-09.

Jack Lee Boone's current location address is 212 Ainsley Ave, Hertford, North Carolina. You can contact this provider via phone number 2524265585 and fax number 2524265766. The mailing address for Jack Lee Boone is 212 Ainsley Ave, Hertford, North Carolina. To know further, please read the information below!

Provider Profile Detail

Provider Name Jack Lee Boone
Address 212 Ainsley Ave, Hertford, North Carolina
Phone Number 2524265585
Fax Number 2524265766
Sole Proprietor N
Credentials DDS

NPI Number Detail

NPI Number 1619907474
Provider Enumeration Date 2006-07-04
Last Updated Date 2007-07-09

Provider Mailing Address Detail

Address 212 Ainsley Ave
City Hertford
State North Carolina (NC)
Post Code 279441400
Phone Number 2524265585
Fax Number 2524265766

Provider's Primary Taxonomy Detail

Speciality General Practice
Taxonomy 1223G0001X
Licence No 3868
Definition:
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Provider's Other Legacy Identifiers

Identifier Identifier Type Identifier State Identifier Issuer
8990862 NC --
90862 NC BCBS PROVIDER ID

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FAQs about Jack Lee Boone

What is the unique 10-digit identification code assigned to Jack Lee Boone by the Centers for Medicare & Medicaid Services?

The Jack Lee Boone has been issued the NPI (National Provider Identifier) 1619907474, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).

Could you please share the complete physical location address where Jack Lee Boone's facilities are situated?

The facilities of Jack Lee Boone are physically located at the following address: 212 Ainsley Ave, Hertford, NC, 279441400.

What is Jack Lee Boone's specialized field of practice, and what is the corresponding taxonomy classification code?

The Jack Lee Boone's area of specialization is General Practice, and the corresponding taxonomy code that categorizes this field of practice is 1223G0001X.

When was the Jack Lee Boone's 1619907474 issued?

The Jack Lee Boone's 1619907474 was issued on 2006-07-04.

As of what date were the Jack Lee Boone's details last updated?

The information pertaining to the Jack Lee Boone, including its address, specialty, and other details, was most recently updated on 2007-07-09.

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