Healthcare Provider Details

I. General information

NPI: 1407814320
Provider Name (Legal Business Name): ASHEVILLE ORTHOPAEDIC ASSOCIATES, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2006
Last Update Date: 11/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 VICTORIA RD
ASHEVILLE NC
28801-4811
US

IV. Provider business mailing address

111 VICTORIA RD
ASHEVILLE NC
28801-4811
US

V. Phone/Fax

Practice location:
  • Phone: 828-252-7331
  • Fax: 828-253-1123
Mailing address:
  • Phone: 828-252-7331
  • Fax: 828-253-1123

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number120426
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: DR. SAMUEL D JARRETT
Title or Position: PRESIDENT
Credential:
Phone: 828-252-7331