Individual
JASON MACHALICKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
901 JONES FRANKLIN RD, RALEIGH, NC 27606-5441
(919) 852-5265
(919) 852-5267
Mailing address
284 EXECUTIVE PARK DR, STE 100, CONCORD, NC 28025-1831
(704) 939-1100
(704) 939-1173
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
200601823
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5907024
—
NC
Enumeration date
05/07/2007
Last updated
11/18/2020
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