Provider Demographics
NPI:1518125483
Name:HONEYCUTT, SAMMY (M D)
Entity Type:Individual
Prefix:DR
First Name:SAMMY
Middle Name:
Last Name:HONEYCUTT
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1615 ELKHART CIR
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-7761
Mailing Address - Country:US
Mailing Address - Phone:704-864-1290
Mailing Address - Fax:
Practice Address - Street 1:1615 ELKHART CIR
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-7761
Practice Address - Country:US
Practice Address - Phone:704-864-1290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-28
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20810208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice