Provider Demographics
NPI:1457503880
Name:HILLTOP FAMILY MEDICINE, PA
Entity Type:Organization
Organization Name:HILLTOP FAMILY MEDICINE, PA
Other - Org Name:JOHN C BETANCOURT MD, PLLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:CLEMENTS
Authorized Official - Last Name:BETANCOURT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:828-874-4600
Mailing Address - Street 1:PO BOX 70
Mailing Address - Street 2:
Mailing Address - City:RUTHERFORD COLLEGE
Mailing Address - State:NC
Mailing Address - Zip Code:28671-0070
Mailing Address - Country:US
Mailing Address - Phone:828-874-4600
Mailing Address - Fax:828-874-8900
Practice Address - Street 1:110 HILLTOP STREET
Practice Address - Street 2:
Practice Address - City:RUTHERFORD COLLEGE
Practice Address - State:NC
Practice Address - Zip Code:28671-0070
Practice Address - Country:US
Practice Address - Phone:828-874-4600
Practice Address - Fax:828-874-8900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-16
Last Update Date:2014-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9800014207Q00000X
NC34D1038246291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No291U00000XLaboratoriesClinical Medical LaboratoryGroup - Single Specialty