HOMETOWN MED OF MOYOCK AND OBX PLLC; NPI #1750021325

Contact Information

HOMETOWN MED OF MOYOCK AND OBX PLLC

109 CURRITUCK COMMERICAL DR STE A
MOYOCK, NC 27958-9068

Phone: 252-772-1110
Fax: 252-319-3678
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Primary Care	363LP2300X	50	Nurse Practitioner
Addiction Medicine	2083A0300X	84	Physician/Preventive Medicine
Family Medicine	207Q00000X	08	Physician/Family Practice
Primary Care	261QP2300X

Indicates primary specialty

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NPI Profile & details for HOMETOWN MED OF MOYOCK AND OBX PLLC

NPI Number 1750021325

LBN Legal business name HOMETOWN MED OF MOYOCK AND OBX PLLC

Authorized official CARMEN WYNES - (OWNER)

Entity Organization

Organization subpart ¹ No

Enumeration date 03/31/2022

Last updated 04/26/2023 - About 3 years ago

Identifiers

NC	Medicaid	1750021325
VA	Medicaid	1073000816

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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HOMETOWN MED OF MOYOCK AND OBX PLLC

Contact Information

Specialty

Primary Care

Addiction Medicine

Family Medicine

Primary Care

NPI Profile & details for HOMETOWN MED OF MOYOCK AND OBX PLLC

Reviews for HOMETOWN MED OF MOYOCK AND OBX PLLC