# FAMILY MEDICAL CARE OF ROWAN-SPENCER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033196837
- **Authorized official:** LLYOD EMERY NICKERSON MD (OWNER MEDICAL DOCTOR)
- **Authorized official phone:** (704) 633-7070

## Contact information

- **Practice address:** 117 5TH ST, SPENCER, NC 28159-2125
- **Practice address phone:** (704) 639-9124
- **Practice address fax:** (704) 639-9717
- **Mailing address:** 300 N SALISBURY AVE, SPENCER, NC 28159-2514
- **Mailing address phone:** (704) 633-7070
- **Mailing address fax:** (704) 633-7627

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/22/2005
- **Last updated:** 01/09/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 89014CE | — | NC |
| 01 | — | CK8333 | RAILROAD MEDICARE | NC |