Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | 380 | NC |
N | 222Z00000X | Podiatrist | 380 | NC |
Y | 213EP1101X | Primary Podiatric Medicine | 380 | NC |
NPI | 1619963048 |
---|---|
Provider Name | Lloyd S Hale |
First Address | Bryson City, NC 28713-1730 |
Second Address | Bryson City, NC 28713-8731 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2005 |
Last Update Date | 22/05/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0800A | BCBS (01) | NC |
890800A | (05) | NC |
U63367 | (02) |