Provider Demographics
NPI:1588647390
Name:PENCE, BILLY JACK (MD)
Entity Type:Individual
Prefix:DR
First Name:BILLY
Middle Name:JACK
Last Name:PENCE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 602373
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-2373
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:119 MOUNTAIN VIEW RD
Practice Address - Street 2:
Practice Address - City:MARS HILL
Practice Address - State:NC
Practice Address - Zip Code:28754-9500
Practice Address - Country:US
Practice Address - Phone:828-689-3507
Practice Address - Fax:828-649-3505
Is Sole Proprietor?:No
Enumeration Date:2005-11-25
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC201001079207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist