Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | OS012658 | PA |
NPI | 1740312487 |
---|---|
Provider Name | Dr. Jeffrey Gerard Coury |
First Address | Whiteville, NC 28472-3601 |
Second Address | Whiteville, NC 28472-3601 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2007 |
Last Update Date | 16/01/2008 |