Provider Demographics
NPI:1982081766
Name:HALES, JOHN DANIEL III (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:DANIEL
Last Name:HALES
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 RIVERVIEW ST
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:NC
Mailing Address - Zip Code:28734-2658
Mailing Address - Country:US
Mailing Address - Phone:828-349-8260
Mailing Address - Fax:828-253-1123
Practice Address - Street 1:190 RIVERVIEW ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NC
Practice Address - Zip Code:28734
Practice Address - Country:US
Practice Address - Phone:828-349-8260
Practice Address - Fax:828-253-1123
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-30
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2018-01079207Q00000X, 207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine