Healthcare Provider Details

I. General information

NPI: 1912376971
Provider Name (Legal Business Name): MISSION HOSPITALS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2015
Last Update Date: 09/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 FALCON CREST LN
CLYDE NC
28721-6620
US

IV. Provider business mailing address

PO BOX 602811
CHARLOTTE NC
28260-2811
US

V. Phone/Fax

Practice location:
  • Phone: 828-255-7776
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM R HATHAWAY
Title or Position: CMO
Credential: MD
Phone: 828-213-0499