Provider Demographics
NPI:1245296227
Name:LI, JOHN (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:LI
Suffix:
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 1:1100 TUNNEL ROAD
Mailing Address - Street 2:SURGERY (112)
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28805-2087
Mailing Address - Country:US
Mailing Address - Phone:828-299-2540
Mailing Address - Fax:
Practice Address - Street 1:1100 TUNNEL ROAD
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28805-2087
Practice Address - Country:US
Practice Address - Phone:828-298-7911
Practice Address - Fax:828-299-2567
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2010-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200001195208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery