Tracy Ivan Earl in Hickory - Physician Assistant
Tracy Ivan Earl - NPI 1053310250
Tracy Ivan Earl is a Physician Assistant in Hickory, North Carolina. Tracy Ivan Earl practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Tracy Ivan Earl is 1053310250. The last update date is 2011-01-21.
Tracy Ivan Earl's current location address is 36 14th Ave Ne, Hickory, North Carolina. You can contact this provider via phone number 8283456468 and fax number 8283451468. The mailing address for Tracy Ivan Earl is 36 14th Ave Ne, Hickory, North Carolina. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Tracy Ivan Earl |
|---|---|
| Address | 36 14th Ave Ne, Hickory, North Carolina |
| Phone Number | 8283456468 |
| Fax Number | 8283451468 |
| Sole Proprietor | N |
| Credentials | P.A. |
NPI Number Detail
| NPI Number | 1053310250 |
|---|---|
| Provider Enumeration Date | 2005-07-19 |
| Last Updated Date | 2011-01-21 |
Provider Mailing Address Detail
| Address | 36 14th Ave Ne |
|---|---|
| City | Hickory |
| State | North Carolina (NC) |
| Post Code | 286012580 |
| Phone Number | 8283456468 |
| Fax Number | 8283451468 |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | 0010-01786 |
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Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 154755 | NC | NORTH CAROLINA MEDICAL BOARD |
Post Comment/ Review Below
Could you please provide the complete physical location address of Tracy Ivan Earl?
The Tracy Ivan Earl is physically situated at 36 14Th Ave Ne, in the city of Hickory, state of NC, with the postal code 286012580.
What is the area of specialization for Tracy Ivan Earl, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Tracy Ivan Earl is Physician Assistant, and the corresponding taxonomy code that categorizes this area of expertise is 363A00000X.
On what date did the Centers for Medicare & Medicaid Services issue the 1053310250 to Tracy Ivan Earl?
The Tracy Ivan Earl received its 1053310250 assignment from the Centers for Medicare & Medicaid Services on 2005-07-19.
When was the Tracy Ivan Earl's information last updated?
The Tracy Ivan Earl's information was last updated on 2011-01-21.
When was the information pertaining to Tracy Ivan Earl most recently updated or revised?
The details related to Tracy Ivan Earl, including its address, specialty, and other relevant information, were last updated or revised on 2011-01-21.