Provider Demographics
NPI:1245455427
Name:PIERCE, IAN ROSS (PT)
Entity type:Individual
Prefix:MR
First Name:IAN
Middle Name:ROSS
Last Name:PIERCE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 GOLDENROD DR
Mailing Address - Street 2:
Mailing Address - City:WHISPERING PINES
Mailing Address - State:NC
Mailing Address - Zip Code:28327-9352
Mailing Address - Country:US
Mailing Address - Phone:910-949-9916
Mailing Address - Fax:
Practice Address - Street 1:170 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:PINEHURST
Practice Address - State:NC
Practice Address - Zip Code:28374-8709
Practice Address - Country:US
Practice Address - Phone:910-715-1825
Practice Address - Fax:910-715-1828
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3441282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital