Healthcare Provider Details

I. General information

NPI: 1487804357
Provider Name (Legal Business Name): TRANSYLVANIA PHYSICIAN SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2008
Last Update Date: 04/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

316 CHESTNUT ST STE 2
BREVARD NC
28712-3897
US

IV. Provider business mailing address

PO BOX 602373
CHARLOTTE NC
28260-2373
US

V. Phone/Fax

Practice location:
  • Phone: 828-884-2055
  • Fax: 828-884-2834
Mailing address:
  • Phone: 828-213-1500
  • Fax: 828-651-6570

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code207XP3100X
TaxonomyPediatric Orthopaedic Surgery Physician
License Number
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License Number
License Number StateNC
# 5
Primary TaxonomyN
Taxonomy Code207XX0004X
TaxonomyOrthopaedic Foot and Ankle Surgery Physician
License Number
License Number StateNC
# 6
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number
License Number StateNC
# 7
Primary TaxonomyN
Taxonomy Code207XX0801X
TaxonomyOrthopaedic Trauma Physician
License Number
License Number StateNC

VIII. Authorized Official

Name: RHONDA A MILLER
Title or Position: CHIEF REVENUE OFFICER
Credential:
Phone: 828-651-4144