# HICKORY LONG TERM CARE

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

## Provider details

- **NPI number:** 1427166032
- **Authorized official:** DR. JOHN EARL MD (PARTNER)
- **Authorized official phone:** (828) 465-0811

## Contact information

- **Practice address:** 1650 5TH ST NW, HICKORY, NC 28601-5208
- **Practice address phone:** (828) 465-0811
- **Practice address fax:** (828) 465-0811
- **Mailing address:** 1650 5TH ST NW, HICKORY, NC 28601-5208
- **Mailing address phone:** (828) 465-0811
- **Mailing address fax:** (828) 465-0811

## Taxonomy

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

## Other

- **Enumeration date:** 08/25/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 014X1 | BCBS | NC |
| 05 | — | 89014X1 | — | NC |
| 01 | — | DA9485 | MEDICARE RAILROAD | NC |