Individual
DR. JOHN KETRON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11840 SOUTHMORE DR, SUITE 200, CHARLOTTE, NC 28277-4466
(704) 384-1166
(704) 384-1181
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-1166
(704) 384-1181
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
29932
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8948792
—
NC
Enumeration date
02/08/2006
Last updated
11/19/2015
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