Provider Demographics
NPI:1891526026
Name:HONEYCUTT, MICHAEL TYLER (PA-C)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:TYLER
Last Name:HONEYCUTT
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
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Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1910 JAKE ALEXANDER BLVD W STE 202
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28147-1165
Practice Address - Country:US
Practice Address - Phone:704-216-5633
Practice Address - Fax:704-603-1451
Is Sole Proprietor?:No
Enumeration Date:2024-08-09
Last Update Date:2024-11-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC0010-14438363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant