Healthcare Provider Details

I. General information

NPI: 1114150190
Provider Name (Legal Business Name): MISSION MEDICAL ASSOCIATES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2009
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

509 BILTMORE AVENUE
ASHEVILLE NC
28801-4601
US

IV. Provider business mailing address

PO BOX 602373
CHARLOTTE NC
28260-2373
US

V. Phone/Fax

Practice location:
  • Phone: 828-213-4411
  • Fax: 828-213-0275
Mailing address:
  • Phone: 828-213-1500
  • Fax: 828-651-6570

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: JILL HOGGARD-GREEN
Title or Position: PRESIDENT
Credential: PHD
Phone: 828-213-0193