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General NPI Number Information
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NPI Number | 1811341027
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Entity Type | Organization
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Legal Business Name | TRIANGLE PHYSICAL MEDICINE OF NORTH HILLS PC
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Dates
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Enumeration Date | 04/14/2016
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Last Update Date | 06/01/2016
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Provider Practice Location Address
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Address Line | 3900 BARRETT DR STE # 101
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City | RALEIGH
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State | NC
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Zip | 27609-6641
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Country | US
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Telephone | 919-809-8860
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Fax | 919-809-8861
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Provider Business Mailing Address
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Address Line | 3900 BARRETT DR STE # 101
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City | RALEIGH
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State | NC
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Zip | 27609-6641
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Country | US
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Telephone | 919-809-8860
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Fax | 919-809-8861
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Authorized Official
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Title or Position | OWNER
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Name | JONATHAN ORTON
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Credential | M.D.
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Telephone | 919-809-8860
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 102815
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 2014-01078
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License Number State | NC
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