Jack Richard Cahn, MD

Individual provider Active NPI Family Medicine Physician · Sparta, NC

NPI 1669444527 · NPPES record last updated Dec 12, 2007

Key facts

NPI
1669444527
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
19788 (NC)
Practice address
214 Doctors St
Sparta, NC 28675-9247
Phone
(336) 372-5606
Fax
(336) 372-6211
NPI assigned
Feb 6, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
19788NCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Alleghany Memorial Hospital Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 19788 NC Yes

Addresses

Primary practice location

214 Doctors St
Sparta, NC 28675-9247

Mailing address

214 Doctors St
Sparta, NC 28675
Phone (336) 372-5606

Other identifiers

IdentifierTypeStateIssuer
21734OtherMEDCOST
5001OtherPARTNERS CHOICE
5603595MedicaidVA
20644OtherNCBCBS
8920644MedicaidNC
0107814OtherUNITIED HEALTHCARE

Other providers in Sparta, NC

All providers in Sparta, NC · Family Medicine Physician in North Carolina

Sources for this page

Verify at the official NPI Registry.