DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: MRS. MARY DEAKLE PA-C

MEDICARE: MRS. MARY DEAKLE PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician Assistant100874NC
2363A00000XPhysician Assistant100874NC

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00654536OTHERNCRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1992762538
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MARY DEAKLE PA-C
Provider Business Mailing Address
First Line : PO BOX 751803
Second Line :
City : CHARLOTTE
State : NC
Zip : 28275-1803
Country : US
Telephone Number : 336-766-6473
Fax Number : 336-766-8909
Provider Business Practice Location Address
First Line : 6301 STADIUM DR
Second Line :
City : CLEMMONS
State : NC
Zip : 27012-8766
Country : US
Telephone Number : 336-766-6473
Fax Number : 336-766-8909
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/27/2006
Last Update Date : 10/28/2020

Similar Medicare Providers

1366446320 — CHRISTOPHER ANDREW MADDEN M.D.
Practice Location Address:
6301 STADIUM DR
CLEMMONS, NC
27012-8766
Practice Phone: 336-766-6473
Practice Fax: 336-766-8909
1992787501 — MRS. DANIELLE MARGUERITE CARTER ADKINS PA-C
Practice Location Address:
6301 STADIUM DR STE 500
CLEMMONS, NC
27012-8766
Practice Phone: 336-766-6473
Practice Fax: 336-766-8909
1326028382 — TERRY MICHAEL DEAKLE PA
Practice Location Address:
6301 STADIUM DR
CLEMMONS, NC
27012-8766
Practice Phone: 336-766-6473
Practice Fax: 336-766-8909
1609835396 — DEBORAH H POLLOCK MD
Practice Location Address:
6301 STADIUM DR
CLEMMONS, NC
27012-8766
Practice Phone: 336-766-6473
Practice Fax: 336-766-8909
1629039870 — WALTER H WRAY MD
Practice Location Address:
6301 STADIUM DR
CLEMMONS, NC
27012-8766
Practice Phone: 336-766-6473
Practice Fax: 336-766-8909
1780642629 — FORSYTH MEMORIAL HOSPITAL INC
Practice Location Address:
6301 STADIUM DR
CLEMMONS, NC
27012-8766
Practice Phone: 336-766-6473
Practice Fax: 336-766-8909

Directions to “ MRS. MARY DEAKLE PA-C” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.