Healthcare Provider Details

I. General information

NPI: 1497942460
Provider Name (Legal Business Name): ORTHOPAEDIC SURGERY CENTER OF ASHEVILLE, LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2007
Last Update Date: 11/30/2021
Certification Date: 11/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29 NETTLEWOOD DRIVE
ASHEVILLE NC
28803
US

IV. Provider business mailing address

29 NETTLEWOOD DRIVE
ASHEVILLE NC
28803
US

V. Phone/Fax

Practice location:
  • Phone: 828-225-0861
  • Fax:
Mailing address:
  • Phone: 828-225-0861
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License NumberAS0038
License Number StateNC

VIII. Authorized Official

Name: JENNIFER BOYD BALDOCK
Title or Position: OFFICER AND AUTHORIZED OFFICIAL
Credential:
Phone: 615-234-5900