Healthcare Provider Details

I. General information

NPI: 1215974597
Provider Name (Legal Business Name): ARCH PODIATRY ASSOCIATES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

335 BILLINGSLEY RD SUITE 102
CHARLOTTE NC
28211-1040
US

IV. Provider business mailing address

335 BILLINGSLEY RD SUITE 102
CHARLOTTE NC
28211-1040
US

V. Phone/Fax

Practice location:
  • Phone: 704-632-8032
  • Fax: 704-632-8034
Mailing address:
  • Phone: 704-632-8032
  • Fax: 704-632-8034

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State

VIII. Authorized Official

Name: JAMES KEVIN HARDISON
Title or Position: PRESIDENT
Credential: D.P.M
Phone: 704-632-8032