Individual
JACK CARLSON SPIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
310 LONG SHOALS RD, # 320, ARDEN, NC 28704-8794
(828) 274-6610
Mailing address
PO BOX 602373, CHARLOTTE, NC 28260-2373
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
9601484
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8976916
—
NC
Enumeration date
07/19/2006
Last updated
10/31/2016
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