Provider Demographics
NPI:1851520050
Name:HARTLEY, JULIA STACY (DO)
Entity Type:Individual
Prefix:DR
First Name:JULIA
Middle Name:STACY
Last Name:HARTLEY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:JULIA
Other - Middle Name:STACY
Other - Last Name:GLICKSBERG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:6750 CAROLINA BLVD
Mailing Address - Street 2:
Mailing Address - City:CLYDE
Mailing Address - State:NC
Mailing Address - Zip Code:28721-7052
Mailing Address - Country:US
Mailing Address - Phone:828-627-2211
Mailing Address - Fax:828-627-2216
Practice Address - Street 1:6750 CAROLINA BLVD
Practice Address - Street 2:
Practice Address - City:CLYDE
Practice Address - State:NC
Practice Address - Zip Code:28721-7052
Practice Address - Country:US
Practice Address - Phone:828-627-2211
Practice Address - Fax:828-627-2216
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-08
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2001-01937207Q00000X
SCLL1280207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine