Provider Demographics
NPI:1245660794
Name:SOLID ROCK FAMILY MEDICINE, INC.
Entity type:Organization
Organization Name:SOLID ROCK FAMILY MEDICINE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:DEATON
Authorized Official - Suffix:
Authorized Official - Credentials:FNP,BC
Authorized Official - Phone:828-438-1587
Mailing Address - Street 1:200B S COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655-3316
Mailing Address - Country:US
Mailing Address - Phone:828-438-1587
Mailing Address - Fax:828-438-1119
Practice Address - Street 1:200B S COLLEGE ST
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-3316
Practice Address - Country:US
Practice Address - Phone:828-438-1587
Practice Address - Fax:828-438-1119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-20
Last Update Date:2013-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC201369261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care