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General NPI Number Information
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NPI Number | 1124485768
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Entity Type | Organization
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Legal Business Name | DLP CENTRAL CAROLINA PHYSICIAN PRACTICES LLC
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Dates
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Enumeration Date | 01/27/2016
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Last Update Date | 01/27/2016
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Provider Practice Location Address
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Address Line | 210 13TH AVENUE PL NW STE 101
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City | HICKORY
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State | NC
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Zip | 28601-2568
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Country | US
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Telephone | 615-920-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 210 13TH AVENUE PL NW STE 101
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City | HICKORY
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State | NC
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Zip | 28601-2568
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Country | US
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Telephone | 615-920-7000
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JESS JUDY
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Credential |
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Telephone | 615-920-7000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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