Healthcare Provider Details

I. General information

NPI: 1457503880
Provider Name (Legal Business Name): HILLTOP FAMILY MEDICINE, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2008
Last Update Date: 10/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 HILLTOP STREET
RUTHERFORD COLLEGE NC
28671-0070
US

IV. Provider business mailing address

PO BOX 70
RUTHERFORD COLLEGE NC
28671-0070
US

V. Phone/Fax

Practice location:
  • Phone: 828-874-4600
  • Fax: 828-874-8900
Mailing address:
  • Phone: 828-874-4600
  • Fax: 828-874-8900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number9800014
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number34D1038246
License Number StateNC

VIII. Authorized Official

Name: DR. JOHN CLEMENTS BETANCOURT
Title or Position: OWNER/PRESIDENT
Credential: MD
Phone: 828-874-4600