Provider Demographics
NPI:1639905987
Name:HOLLY SPRINGS DIRECT PRIMARY CARE, PLLC
Entity type:Organization
Organization Name:HOLLY SPRINGS DIRECT PRIMARY CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:BARTKOSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:984-464-4764
Mailing Address - Street 1:229 ROSTOVA WAY
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:27540-4956
Mailing Address - Country:US
Mailing Address - Phone:573-280-9686
Mailing Address - Fax:
Practice Address - Street 1:1100 HOLLY SPRINGS RD STE 203
Practice Address - Street 2:
Practice Address - City:HOLLY SPRINGS
Practice Address - State:NC
Practice Address - Zip Code:27540-9469
Practice Address - Country:US
Practice Address - Phone:984-464-4764
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-12
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care