Healthcare Provider Details

I. General information

NPI: 1326033937
Provider Name (Legal Business Name): FRANKLIN R EVERHART PA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2005
Last Update Date: 10/16/2019
Certification Date:
Deactivation Date: 03/23/2006
Reactivation Date: 03/31/2006

III. Provider practice location address

611 RANDOLPH ST
THOMASVILLE NC
27360-5126
US

IV. Provider business mailing address

200 E SECOND AVE
GASTONIA NC
28052-4358
US

V. Phone/Fax

Practice location:
  • Phone: 336-474-4585
  • Fax: 336-474-3438
Mailing address:
  • Phone: 704-874-1904
  • Fax: 704-867-2134

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number102847
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: