Healthcare Provider Details

I. General information

NPI: 1972735603
Provider Name (Legal Business Name): PARKWAY INTERNAL MEDICINE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2009
Last Update Date: 02/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5045 HICKORY BLVD
HICKORY NC
28601-8920
US

IV. Provider business mailing address

PO BOX 509
SYLVA NC
28779-0509
US

V. Phone/Fax

Practice location:
  • Phone: 828-212-1020
  • Fax:
Mailing address:
  • Phone: 828-339-7268
  • Fax: 828-586-8209

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name: BRADFORD W LAWRENCE
Title or Position: OWNER/PRESIDENT
Credential: PA-C
Phone: 828-212-1020