Healthcare Provider Details

I. General information

NPI: 1225142011
Provider Name (Legal Business Name): HORIZON SURGICAL SPECIALISTS PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2006
Last Update Date: 12/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 MULBERRY ST SW STE 101
LENOIR NC
28645-1648
US

IV. Provider business mailing address

PO BOX 1648 401 MULBERRY ST SW STE 101
LENOIR NC
28645-1648
US

V. Phone/Fax

Practice location:
  • Phone: 828-758-5501
  • Fax: 828-758-0080
Mailing address:
  • Phone: 828-758-5501
  • Fax: 828-758-0080

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number2013-01463
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number9800782
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number9701115
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number8387
License Number StateNC
# 5
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: DR. PETER NELSON PURCELL
Title or Position: MD OWNER
Credential: MD
Phone: 828-758-5501