Provider Demographics
NPI:1053318246
Name:BRITTON, MARY J (MD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:J
Last Name:BRITTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 TATE BLVD SE STE 186
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28602-4042
Mailing Address - Country:US
Mailing Address - Phone:828-449-8458
Mailing Address - Fax:828-323-8348
Practice Address - Street 1:915 TATE BLVD SE STE 186
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-4042
Practice Address - Country:US
Practice Address - Phone:828-449-8458
Practice Address - Fax:828-323-8348
Is Sole Proprietor?:No
Enumeration Date:2005-07-01
Last Update Date:2015-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200000369207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8912602Medicaid
990015426OtherRAILROAD MEDICARE
NC12602OtherBCBS
NC2281079Medicare ID - Type Unspecified
990015426OtherRAILROAD MEDICARE
H16683Medicare UPIN
NC8912602Medicaid