Healthcare Provider Details

I. General information

NPI: 1548446693
Provider Name (Legal Business Name): GREATER HICKORY FAMILY MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2008
Last Update Date: 01/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2336 1ST AVE SW
HICKORY NC
28602-2007
US

IV. Provider business mailing address

2336 1ST AVE SW
HICKORY NC
28602-2007
US

V. Phone/Fax

Practice location:
  • Phone: 828-431-4988
  • Fax: 828-431-4990
Mailing address:
  • Phone: 828-431-4988
  • Fax: 828-431-4990

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number
License Number State

VIII. Authorized Official

Name: DR. DANIEL NEWELL GILL
Title or Position: OWNER/DOCTOR
Credential:
Phone: 828-431-4988