Healthcare Provider Details

I. General information

NPI: 1912956780
Provider Name (Legal Business Name): 24 ON PHYSICIANS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2006
Last Update Date: 05/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3990 E US 64 ALT
MURPHY NC
28906-6843
US

IV. Provider business mailing address

P.O. BOX 849318
BOSTON MA
02284-9318
US

V. Phone/Fax

Practice location:
  • Phone: 828-837-5939
  • Fax: 828-835-7569
Mailing address:
  • Phone: 770-740-0895
  • Fax: 770-740-0896

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: DAN A. FULLER
Title or Position: SECRETARY
Credential:
Phone: 770-740-0895