Provider Demographics
NPI:1356773261
Name:PEGRAM, JOSEPH LEE JR (RPSGT)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:LEE
Last Name:PEGRAM
Suffix:JR
Gender:M
Credentials:RPSGT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 HOSPITAL DR
Mailing Address - Street 2:SUITE 1C
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28792-5248
Mailing Address - Country:US
Mailing Address - Phone:828-654-6000
Mailing Address - Fax:
Practice Address - Street 1:50 HOSPITAL DR
Practice Address - Street 2:SUITE 1C
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28792-5248
Practice Address - Country:US
Practice Address - Phone:828-654-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-01
Last Update Date:2013-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
14877246Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other