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General NPI Number Information
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NPI Number | 1376963702
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Entity Type | Organization
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Legal Business Name | MISSION MEDICAL ASSOCIATES, INC
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Dates
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Enumeration Date | 04/24/2014
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Last Update Date | 08/22/2014
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Provider Practice Location Address
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Address Line | 111 VICTORIA RD
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City | ASHEVILLE
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State | NC
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Zip | 28801-4811
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Country | US
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Telephone | 828-252-7331
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Fax | 828-253-1123
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Provider Business Mailing Address
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Address Line | PO BOX 602998
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City | CHARLOTTE
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State | NC
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Zip | 28260-2998
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Country | US
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Telephone | 828-651-6474
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JILL HOGGARD-GREEN
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Credential | PHD
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Telephone | 828-213-9637
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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