Healthcare Provider Details

I. General information

NPI: 1275943698
Provider Name (Legal Business Name): DLP RUTHERFORD PHYSICIAN PRACTICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2014
Last Update Date: 09/16/2024
Certification Date: 09/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

139 DOCTOR HENRY NORRIS DR
RUTHERFORDTON NC
28139-3176
US

IV. Provider business mailing address

139 DOCTOR HENRY NORRIS DR
RUTHERFORDTON NC
28139-3176
US

V. Phone/Fax

Practice location:
  • Phone: 828-287-9260
  • Fax:
Mailing address:
  • Phone: 828-287-9260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: CHARLOTTE LAWRENCE
Title or Position: SECRETARY
Credential:
Phone: 615-920-7000