Ian Stack PA

NPI 1154590529 - Physician Assistant - 363AM0700X

NPI Details
NPI 1154590529
Gender Male
Enumeration Date 02/29/2008
Last Updated 02/29/2008
Entity Type Individual
Active Over 8 years ago
Practice Location
35 MEMORIAL DR
PINEHURST NC, 28374-8708, US
Phone (910) 715-7856
Fax
Business Location
126 JAMES CREEK RD
SOUTHERN PINES NC, 28387-6819, US
Phone (910) 692-8224
Fax
Toxanomy
Taxonomy Code 363AM0700X
License State North Carolina
License Number 103480
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According to our database, Ian Stack PA NPI is 1154590529, taxonomy code is 363AM0700X and license number is 103480, license state is located at North Carolina. Ian Stack PA physically located at 35 Memorial Dr, Pinehurst NC, 28374-8708. NPI Number Ian Stack PA has the Individual type.

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1154590529 NPI number is provided on an as is basis without warranty of any kind. 1154590529 is maintained by the National Plan & Provider Enumeration System. The contents of Ian Stack PA are for informational purposes only.