Provider Demographics
NPI:1821011420
Name:THRELKELD, BILLIE J (MD)
Entity type:Individual
Prefix:
First Name:BILLIE
Middle Name:J
Last Name:THRELKELD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 629, 2100 STANTONSBURG RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27835-2545
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1403 S KING ST
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:NC
Practice Address - Zip Code:27983
Practice Address - Country:US
Practice Address - Phone:252-794-6693
Practice Address - Fax:330-493-8677
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200300717207P00000X
NC2003-00717207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89134AUMedicaid
NC89134AUMedicaid
NCTH4100221Medicare ID - Type Unspecified