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General NPI Number Information
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NPI Number | 1376599969
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Entity Type | Organization
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Legal Business Name | EAR, SINUS AND ALLERGY CENTER
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Dates
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Enumeration Date | 05/25/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1190 DREXEL RD
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City | VALDESE
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State | NC
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Zip | 28690-9570
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Country | US
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Telephone | 828-438-1930
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Fax | 828-438-1937
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Provider Business Mailing Address
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Address Line | PO BOX 271
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City | RUTHERFORD COLLEGE
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State | NC
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Zip | 28671-0271
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Country | US
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Telephone | 828-438-1930
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Fax | 828-438-1937
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. EDWARD BRUCE JONES
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Credential | M.D.
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Telephone | 828-438-1930
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 9300167
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License Number State | NC
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