Healthcare Provider Details

I. General information

NPI: 1295710085
Provider Name (Legal Business Name): JOHN F. BAUMRUCKER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/14/2005
Last Update Date: 06/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 HOSPITAL DR SUITE #304
HIGHLANDS NC
28741-7623
US

IV. Provider business mailing address

209 HOSPITAL DR SUITE #304
HIGHLANDS NC
28741-7623
US

V. Phone/Fax

Practice location:
  • Phone: 828-526-1700
  • Fax: 828-787-2451
Mailing address:
  • Phone: 828-526-1700
  • Fax: 828-787-2451

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number17200
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number17200
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: