Healthcare Provider Details

I. General information

NPI: 1053313262
Provider Name (Legal Business Name): SYLVA ORTHOPAEDIC ASSOCIATES, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2005
Last Update Date: 06/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 HEALTHCARE DR STE 203
SYLVA NC
28779-5146
US

IV. Provider business mailing address

80 HEALTHCARE DR STE 203
SYLVA NC
28779-5146
US

V. Phone/Fax

Practice location:
  • Phone: 828-586-5531
  • Fax: 828-586-5759
Mailing address:
  • Phone: 828-586-5531
  • Fax: 828-586-5759

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number40411
License Number StateNC

VIII. Authorized Official

Name: LAWRENCE FRANCIS SUPIK
Title or Position: MANAGING PARTNER
Credential: MD
Phone: 828-586-5531