Healthcare Provider Details

I. General information

NPI: 1760437677
Provider Name (Legal Business Name): HICKORY ORTHOPAEDIC CENTER, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 04/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

214 18TH ST SE
HICKORY NC
28602-1363
US

IV. Provider business mailing address

214 18TH ST SE
HICKORY NC
28602-1363
US

V. Phone/Fax

Practice location:
  • Phone: 828-322-5172
  • Fax: 828-485-2164
Mailing address:
  • Phone: 828-322-5172
  • Fax: 828-485-2164

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: ELIZABETH PADGETT
Title or Position: ADMINISTRATIVE ASSISTANT
Credential:
Phone: 828-322-5172