Healthcare Provider Details

I. General information

NPI: 1548296015
Provider Name (Legal Business Name): JOINT REPLACEMENT SPECIALISTS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2006
Last Update Date: 01/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36 14TH AVE NE SUITE 102
HICKORY NC
28601-2580
US

IV. Provider business mailing address

36 14TH AVE NE SUITE 103
HICKORY NC
28601-2580
US

V. Phone/Fax

Practice location:
  • Phone: 828-345-6468
  • Fax: 828-345-1468
Mailing address:
  • Phone: 828-345-6468
  • Fax: 828-345-1468

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State

VIII. Authorized Official

Name: EDWIN LOUIS PEAK,
Title or Position: PRESIDENT, OWNER
Credential: M.D.
Phone: 828-345-6468