Organization
HICKORY LONG TERM CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN EARL MD (PARTNER)
(828) 465-0811
Entity
Organization
Contact information
Practice address
1650 5TH ST NW, HICKORY, NC 28601-5208
(828) 465-0811
(828) 465-0811
Mailing address
1650 5TH ST NW, HICKORY, NC 28601-5208
(828) 465-0811
(828) 465-0811
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
014X1
BCBS
NC
05
—
89014X1
—
NC
01
—
DA9485
MEDICARE RAILROAD
NC
Enumeration date
08/25/2006
Last updated
08/22/2020
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