Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0002X | Hospice and Palliative Medicine | 2006-00764 | NC |
NPI | 1356325856 |
---|---|
Provider Name | John M Kerr III |
First Address | Pinehurst, NC 28374-8710 |
Second Address | Pinehurst, NC 28374-8710 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/11/2005 |
Last Update Date | 04/03/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1356325856 | (05) | NC |
H85484 | (02) |