Provider Demographics
NPI:1730227901
Name:MIDDLETON, JOHN FOSTER (MA)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:FOSTER
Last Name:MIDDLETON
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 W FLEMING DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655-3966
Mailing Address - Country:US
Mailing Address - Phone:828-438-6218
Mailing Address - Fax:828-439-2340
Practice Address - Street 1:420 W FLEMING DR
Practice Address - Street 2:SUITE C
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-3966
Practice Address - Country:US
Practice Address - Phone:828-438-6218
Practice Address - Fax:828-439-2340
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2013-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0370103TC0700X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6107339Medicaid
NC144P8OtherBCBS