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NPI Code Detail

MEDICARE: HARVEY C OLLEY P.A.

MEDICARE: HARVEY C OLLEY P.A.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant100323NC

General Provider Information

NPI Number : 1215035506
Entity Type Code : Individual
Provider Name (Legal Business Name) : HARVEY C OLLEY P.A.
Provider Business Mailing Address
First Line : PO BOX 578
Second Line :
City : DALLAS
State : NC
Zip : 28034-0578
Country : US
Telephone Number : 704-923-0446
Fax Number : 704-923-8319
Provider Business Practice Location Address
First Line : 107 N SUMMEY ST
Second Line :
City : DALLAS
State : NC
Zip : 28034-1824
Country : US
Telephone Number : 704-923-0446
Fax Number : 704-923-8319
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2006
Last Update Date : 07/08/2007

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Directions to “ HARVEY C OLLEY P.A.” Practice Location

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