Healthcare Provider Details

I. General information

NPI: 1831449057
Provider Name (Legal Business Name): HICKORY FAMILY PRACTICE ASSOCIATES-TENET NORTH CAROLINA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2012
Last Update Date: 07/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

52 12TH AVE NE
HICKORY NC
28601-2798
US

IV. Provider business mailing address

52 12TH AVE NE
HICKORY NC
28601-2798
US

V. Phone/Fax

Practice location:
  • Phone: 828-328-2941
  • Fax: 828-328-4049
Mailing address:
  • Phone: 828-328-2941
  • Fax: 828-328-4049

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. WESLEY O. JAMES
Title or Position: REGIONAL CFO, TENET
Credential:
Phone: 404-265-5009