Healthcare Provider Details

I. General information

NPI: 1447316625
Provider Name (Legal Business Name): JOE P HURT MD,PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

969 MONTEITH BRANCH RD
SYLVA NC
28779-7749
US

IV. Provider business mailing address

969 MONTEITH BRANCH RD
SYLVA NC
28779-7749
US

V. Phone/Fax

Practice location:
  • Phone: 828-586-5724
  • Fax: 828-586-7982
Mailing address:
  • Phone: 828-586-5724
  • Fax: 828-586-7982

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number14691
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: