Provider Demographics
NPI:1033128822
Name:UNIFOUR FAMILY PRACTICE, PLLC
Entity Type:Organization
Organization Name:UNIFOUR FAMILY PRACTICE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:HAMMILL
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:828-294-4100
Mailing Address - Street 1:2874 NC HWY 127 SOUTH
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28602-9130
Mailing Address - Country:US
Mailing Address - Phone:828-294-4100
Mailing Address - Fax:828-294-4112
Practice Address - Street 1:2874 NC HWY 127 SOUTH
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-9130
Practice Address - Country:US
Practice Address - Phone:828-294-4100
Practice Address - Fax:828-294-4112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-08
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0238GOtherBCSC GROUP
NC890238GMedicaid
NC0238GOtherBCBS
NC2342928Medicare PIN
NC2335809Medicare PIN