Provider Demographics
NPI:1679547533
Name:HIVELY, JEFFREY WAYNE (MD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:WAYNE
Last Name:HIVELY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:174 BOLICK LN STE 202
Mailing Address - Street 2:
Mailing Address - City:TAYLORSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28681-4362
Mailing Address - Country:US
Mailing Address - Phone:828-732-5680
Mailing Address - Fax:828-732-5681
Practice Address - Street 1:174 BOLICK LN STE 202
Practice Address - Street 2:
Practice Address - City:TAYLORSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28681-4362
Practice Address - Country:US
Practice Address - Phone:828-732-5680
Practice Address - Fax:828-732-5681
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101247969207Q00000X
NC2022-03128207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVF84465Medicare UPIN