Healthcare Provider Details

I. General information

NPI: 1952830432
Provider Name (Legal Business Name): FHPG, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2017
Last Update Date: 01/07/2025
Certification Date: 01/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

522 ALLEN ST STE 203
TROY NC
27371-2861
US

IV. Provider business mailing address

522 ALLEN ST STE 203
TROY NC
27371-2861
US

V. Phone/Fax

Practice location:
  • Phone: 910-571-5170
  • Fax: 910-571-5175
Mailing address:
  • Phone: 910-571-5170
  • Fax: 910-571-5175

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MICKEY FOSTER
Title or Position: CEO
Credential:
Phone: 910-715-4473