Illsley, John
Illsley, John is an individual health care provider with primary practice located at 702 N Main St , Roxboro NC 27573-4755. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Illsley, John can be contacted via phone (336) 599-9271.Contact Information
Primary practice address
702 N Main St
Roxboro NC 27573-4755
Phone: (336) 599-9271
Fax: (336) 599-9271
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 0010-07223 | North Carolina |
Profile Details
| NPI number | 1598291163 |
|---|---|
| LBN Legal business name | Illsley, John |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 2nd, 2017 |
| Last updated | Jun 18th, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1598291163 | NPPES |
| North Carolina | MEDICAID | 1598291163 |
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