Healthcare Provider Details

I. General information

NPI: 1427612621
Provider Name (Legal Business Name): ANSON BRUCE ALVIS M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2019
Last Update Date: 02/18/2021
Certification Date: 02/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2579 CHIMNEY ROCK RD
HENDERSONVILLE NC
28792-9181
US

IV. Provider business mailing address

123 HENDERSONVILLE ROAD
ASHEVILLE NC
28803
US

V. Phone/Fax

Practice location:
  • Phone: 828-692-4289
  • Fax: 828-696-1794
Mailing address:
  • Phone: 828-257-4472
  • Fax: 828-257-4738

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number250514Q
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number250514
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: