Provider Demographics
NPI:1245231935
Name:LARTEY, PHILIP L (MD)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:L
Last Name:LARTEY
Suffix:
Gender:M
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:PO BOX 1869
Mailing Address - Street 2:
Mailing Address - City:FLETCHER
Mailing Address - State:NC
Mailing Address - Zip Code:28732-1869
Mailing Address - Country:US
Mailing Address - Phone:828-687-5616
Mailing Address - Fax:828-650-8076
Practice Address - Street 1:50 HOSPITAL DR
Practice Address - Street 2:SUITE 5 A
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28792-5247
Practice Address - Country:US
Practice Address - Phone:828-684-1115
Practice Address - Fax:828-687-6064
Is Sole Proprietor?:No
Enumeration Date:2005-08-03
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2004005372084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00184314OtherRAILROAD MEDICARE B
NC13643OtherBCBS
NC8913643Medicaid
NC2026549Medicare PIN
NC8913643Medicaid