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Organization

FAMILY MEDICAL CARE OF ROWAN-SPENCER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LLYOD EMERY NICKERSON MD (OWNER MEDICAL DOCTOR)
(704) 633-7070
Entity
Organization

Contact information

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

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
89014CE
NC
01
CK8333
RAILROAD MEDICARE
NC
Enumeration date
12/22/2005
Last updated
01/09/2008
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