Healthcare Provider Details

I. General information

NPI: 1083979587
Provider Name (Legal Business Name): COUNTY OF HAYWOOD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2012
Last Update Date: 10/31/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

157 PARAGON PARKWAY SUITE 700
CLYDE NC
28721
US

IV. Provider business mailing address

157 PARAGON PARKWAY SUITE 700
CLYDE NC
28721
US

V. Phone/Fax

Practice location:
  • Phone: 828-452-6701
  • Fax: 828-452-6619
Mailing address:
  • Phone: 828-452-6701
  • Fax: 828-452-6619

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: PATRICK H. JOHNSON
Title or Position: PUBLIC HEALTH DIRECTOR
Credential: RN C,MPA,PUBLIC HEAL
Phone: 828-452-6675