Healthcare Provider Details

I. General information

NPI: 1629673355
Provider Name (Legal Business Name): ROBERT TAIT PIERCY PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2020
Last Update Date: 06/16/2023
Certification Date: 06/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HOSPITAL DR STE 4100
ASHEVILLE NC
28801-4550
US

IV. Provider business mailing address

1 HOSPITAL DR
ASHEVILLE NC
28801-4550
US

V. Phone/Fax

Practice location:
  • Phone: 828-337-9676
  • Fax:
Mailing address:
  • Phone: 828-254-8883
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0010-12468
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number0010-12468
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number0010-12468
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: