Southard, John K
Southard, John K is an individual health care provider with primary practice located at 1345B Westgate Center Dr , Winston-Salem NC 27103-2934. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Dermatology. Other Service Providers / Specialist is his primary health care specialty. Southard, John K can be contacted via phone (336) 768-1280.Contact Information
Primary practice address
1345B Westgate Center Dr
Winston-Salem NC 27103-2934
Phone: (336) 768-1280
Fax: (336) 760-8443
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 18576 | North Carolina |
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 18576 | North Carolina |
Profile Details
| NPI number | 1649267535 |
|---|---|
| LBN Legal business name | Southard, John K |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 5th, 2005 |
| Last updated | Apr 8th, 2009 - about 15 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 | 1649267535 | NPPES |
| North Carolina | MEDICAID | 89013U8 | |
| North Carolina | MEDICAID | Q18576 |
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