Provider Demographics
NPI:1831449057
Name:HICKORY FAMILY PRACTICE ASSOCIATES-TENET NORTH CAROLINA, LLC
Entity type:Organization
Organization Name:HICKORY FAMILY PRACTICE ASSOCIATES-TENET NORTH CAROLINA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGIONAL CFO, TENET
Authorized Official - Prefix:MR
Authorized Official - First Name:WESLEY
Authorized Official - Middle Name:O
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-265-5009
Mailing Address - Street 1:52 12TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-2798
Mailing Address - Country:US
Mailing Address - Phone:828-328-2941
Mailing Address - Fax:828-328-4049
Practice Address - Street 1:52 12TH AVE NE
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-2798
Practice Address - Country:US
Practice Address - Phone:828-328-2941
Practice Address - Fax:828-328-4049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-14
Last Update Date:2016-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty