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General NPI Number Information
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NPI Number | 1376009787
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Entity Type | Organization
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Legal Business Name | DAVIDSON RIVER FAMILY MEDICINE PLLC
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Dates
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Enumeration Date | 02/11/2019
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Last Update Date | 02/11/2019
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Provider Practice Location Address
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Address Line | 317 CHESTNUT ST
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City | BREVARD
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State | NC
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Zip | 28712-3898
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Country | US
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Telephone | 828-226-1980
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Fax | 949-404-6183
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Provider Business Mailing Address
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Address Line | 325 E MAIN ST
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City | BREVARD
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State | NC
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Zip | 28712-3834
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Country | US
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Telephone | 828-226-1980
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Fax | 949-404-6183
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Authorized Official
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Title or Position | OWNER
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Name | THOMAS FOWLER LINDSAY
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Credential | MD
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Telephone | 828-226-1980
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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