| NPI | 1114497344 |
|---|---|
| Other Name | PHYSICIAN ASSISTANT |
| Entity Type | Organization |
| Authorized Contact | CAROL HILL Provider Enrollment Specialist 828-651-6579 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
| 363AS0400X Physician Assistant, Surgical | |
| Enumeration Date | 2018-11-30 |
| Last Update Date | 2018-12-03 |