Provider Demographics
NPI:1972545812
Name:PLUM SPRING CLINIC, P.A.
Entity type:Organization
Organization Name:PLUM SPRING CLINIC, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GASKILL
Authorized Official - Middle Name:
Authorized Official - Last Name:CHRISTINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-945-0300
Mailing Address - Street 1:104 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27516
Mailing Address - Country:US
Mailing Address - Phone:919-945-0300
Mailing Address - Fax:919-945-0303
Practice Address - Street 1:104 MARKET ST
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27516
Practice Address - Country:US
Practice Address - Phone:919-945-0300
Practice Address - Fax:919-945-0303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-12
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2344626Medicare PIN
NC5547370001Medicare NSC