Provider Demographics
NPI:1255314134
Name:LABS, JOHN (PA)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:LABS
Suffix:
Gender:M
Credentials:PA
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 1844
Mailing Address - Street 2:
Mailing Address - City:BRYSON CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28713-1844
Mailing Address - Country:US
Mailing Address - Phone:980-270-6770
Mailing Address - Fax:828-538-4441
Practice Address - Street 1:1900 RANDOLPH RD STE 1016
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28207-1117
Practice Address - Country:US
Practice Address - Phone:704-347-3447
Practice Address - Fax:704-347-3440
Is Sole Proprietor?:No
Enumeration Date:2005-11-23
Last Update Date:2019-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC103861363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1255314134Medicaid
NC1611COtherBCBS NC
NC1255314134Medicaid
NCQ00457Medicare UPIN
NCNCA449BMedicare PIN