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General NPI Number Information
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NPI Number | 1245426618
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Entity Type | Organization
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Legal Business Name | ROCKWELL MEDICAL CLINIC
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Dates
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Enumeration Date | 09/19/2007
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Last Update Date | 08/13/2008
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Provider Practice Location Address
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Address Line | 307 E MAIN ST
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City | ROCKWELL
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State | NC
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Zip | 28138-6761
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Country | US
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Telephone | 704-279-7227
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Fax | 704-279-8984
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Provider Business Mailing Address
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Address Line | PO BOX 1060
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City | ROCKWELL
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State | NC
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Zip | 28138-1060
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Country | US
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Telephone | 704-279-7227
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Fax |
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Authorized Official
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Title or Position | FAMILY PRACTITIONER
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Name | JOSEPH ANDREW OLIVER III
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Credential | MD
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Telephone | 704-279-7227
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 173000000X
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Taxonomy Name | Legal Medicine
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License Number | 95-01366
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License Number State | NC
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