1053177923 NPI number — KNOWLES, SMITH & ASSOCIATES, LLP

Table of content: (NPI 1053177923)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053177923 NPI number — KNOWLES, SMITH & ASSOCIATES, LLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KNOWLES, SMITH & ASSOCIATES, LLP
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1053177923
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/27/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2028 LITHO PL STE 300
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FAYETTEVILLE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28304-2538
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
910-485-7070
Provider Business Mailing Address Fax Number:
910-485-1151

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1008 HUTTON LN STE 112
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HIGH POINT
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27262-7245
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-887-9277
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/27/2024

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
PATE
Authorized Official First Name:
MARY
Authorized Official Middle Name:
C
Authorized Official Title or Position:
REVENUE CYCLE DIRECTOR
Authorized Official Telephone Number:
910-484-7070

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1223P0221X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)