Healthcare Provider Details
I. General information
NPI: 1801807672
Provider Name (Legal Business Name): SULPHER SPRINGS HEALTH CENTER, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/10/2006
Last Update Date: 04/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
876 NEW LEICESTER HWY SUITE 3
ASHEVILLE NC
28806-1049
US
IV. Provider business mailing address
PO BOX 1689
ETOWAH NC
28729-1689
US
V. Phone/Fax
- Phone: 828-683-9540
- Fax: 828-683-9615
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
PAUL
S.
CHANG
Title or Position: DOCTOR/ OWNER
Credential: M.D.
Phone: 828-683-9540