Healthcare Provider Details

I. General information

NPI: 1366140352
Provider Name (Legal Business Name): BRIAN THOMAS HEGARTY DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/20/2023
Last Update Date: 02/23/2023
Certification Date: 02/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2165 MEDICAL PARK DR
HICKORY NC
28602-8809
US

IV. Provider business mailing address

174 PATRICK MURPHY DR APT 35
MORGANTON NC
28655-4864
US

V. Phone/Fax

Practice location:
  • Phone: 828-324-2800
  • Fax:
Mailing address:
  • Phone: 919-586-2057
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberP22036
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: