Provider Demographics
NPI:1598586307
Name:DRS FARRELL FARRELL NALE COOK KAPITAN MOHAMED FRANCO WESSEL HOWELL & K
Entity type:Organization
Organization Name:DRS FARRELL FARRELL NALE COOK KAPITAN MOHAMED FRANCO WESSEL HOWELL & K
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PAYOR RELATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:RAYLE
Authorized Official - Last Name:HOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-295-4653
Mailing Address - Street 1:5550 77 CENTER DR STE 320
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28217-0739
Mailing Address - Country:US
Mailing Address - Phone:704-295-4272
Mailing Address - Fax:
Practice Address - Street 1:9335 BLAKENEY CENTRE DR STE 130
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-6665
Practice Address - Country:US
Practice Address - Phone:704-541-7761
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DRS FARRELL FARRELL NALE COOK KAPITAN MOHAMED FRANCO WESSEL HOWELL & K
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-10-23
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
No1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty