Provider Demographics
NPI:1821074055
Name:HALPIN, JOHN J (PA-C)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:J
Last Name:HALPIN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 WILLIAM PENN PLZ
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27704-2150
Mailing Address - Country:US
Mailing Address - Phone:919-220-5255
Mailing Address - Fax:919-220-6971
Practice Address - Street 1:162 LEGACY OAKS DR
Practice Address - Street 2:SUITE 101
Practice Address - City:KNIGHTDALE
Practice Address - State:NC
Practice Address - Zip Code:27545-6501
Practice Address - Country:US
Practice Address - Phone:919-232-5205
Practice Address - Fax:919-373-7890
Is Sole Proprietor?:No
Enumeration Date:2005-12-20
Last Update Date:2009-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC101568363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCS88543Medicare UPIN
NC2503762AMedicare PIN