Healthcare Provider Details

I. General information

NPI: 1063427508
Provider Name (Legal Business Name): HALLMARK FAMILY PHYSICIANS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 12/14/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1766 CONNELLY SPRINGS RD
LENOIR NC
28645-7827
US

IV. Provider business mailing address

PO BOX 710
LENOIR NC
28645-0710
US

V. Phone/Fax

Practice location:
  • Phone: 828-728-8224
  • Fax: 828-728-1690
Mailing address:
  • Phone: 828-757-5070
  • Fax: 828-757-7882

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DONALD F GARDNER JR.
Title or Position: VP/ CFO/CCO
Credential:
Phone: 828-757-5221