Provider Demographics
NPI:1285720284
Name:IACONO, JULIE LINDSEY (MD)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:LINDSEY
Last Name:IACONO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JULIE
Other - Middle Name:A
Other - Last Name:LINDSEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 1869
Mailing Address - Street 2:
Mailing Address - City:FLETCHER
Mailing Address - State:NC
Mailing Address - Zip Code:28732-1869
Mailing Address - Country:US
Mailing Address - Phone:828-687-5616
Mailing Address - Fax:828-650-8076
Practice Address - Street 1:50 HOSPITAL DR
Practice Address - Street 2:STE 5A
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28792-5248
Practice Address - Country:US
Practice Address - Phone:828-684-1115
Practice Address - Fax:828-687-6064
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC96013782084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89133TRMedicaid
NCP00958836OtherRR MEDICARE
NC133TROtherBCBS OF NC
NC2026549Medicare PIN
NC2077452Medicare PIN
NCF70647Medicare UPIN
NC2233532DMedicare PIN