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General NPI Number Information
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NPI Number | 1477876167
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Entity Type | Organization
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Legal Business Name | MISSION MEDICAL LLC
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Dates
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Enumeration Date | 03/09/2010
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Last Update Date | 02/06/2012
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Provider Practice Location Address
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Address Line | 105A N MAIN AVE
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City | NEWTON
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State | NC
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Zip | 28658-3213
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Country | US
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Telephone | 828-455-2049
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Fax | 828-464-3373
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Provider Business Mailing Address
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Address Line | 105A N MAIN AVE
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City | NEWTON
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State | NC
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Zip | 28658-3213
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Country | US
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Telephone | 828-465-9737
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Fax | 828-465-9739
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. CLAUDE MURRAY BARTLEY
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Credential | M.D
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Telephone | 828-455-2049
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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 | 34246
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License Number State | NC
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