Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 38988 | NC |
N | 207YP0228X | Pediatric Otolaryngology | 38988 | NC |
NPI | 1942206958 |
---|---|
Provider Name | Dr. Bennie L Jarvis |
First Address | Morrisville, NC 27560-8442 |
Second Address | Rocky Mount, NC 27804-1470 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2005 |
Last Update Date | 10/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8945851 | (05) | NC |
E51665 | (02) | NC |