Staton, Tara M
Staton, Tara M is an individual health care provider with primary practice located at 2609 Medical Office Pl , Goldsboro NC 27534-9428. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Staton, Tara M can be contacted via phone (919) 734-1779.Contact Information
Primary practice address
2609 Medical Office Pl
Goldsboro NC 27534-9428
Phone: (919) 734-1779
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 000001902 | North Carolina |
Profile Details
| NPI number | 1649253360 |
|---|---|
| LBN Legal business name | Staton, Tara M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 28th, 2005 |
| Last updated | Feb 1st, 2011 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1649253360 | NPPES |
| North Carolina | MEDICAID | 89134VY | |
| North Carolina | Other | P00314273 | |
| North Carolina | Other | 188452 | |
| North Carolina | Other | 134VY | |
| North Carolina | Other | 8565117 |
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