=====================================================
General NPI Number Information
=====================================================
NPI Number | 1447229984
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JOSEPH P ISLEY MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/16/2006
-----------------------------------------------------
Last Update Date | 03/07/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 364 WHITE OAK ST
-----------------------------------------------------
City | ASHEBORO
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27203-5434
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 336-625-5151
-----------------------------------------------------
Fax | 336-633-7754
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 4997
-----------------------------------------------------
City | ASHEBORO
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27204-4997
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 336-830-9192
-----------------------------------------------------
Fax | 336-768-1143
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | 9901422
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------