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General NPI Number Information
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NPI Number | 1548443435
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Entity Type | Organization
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Legal Business Name | WESTERN CAROLINA PHYSICIAN NETWORK
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Dates
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Enumeration Date | 12/13/2007
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Last Update Date | 09/02/2010
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Provider Practice Location Address
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Address Line | 35 FACILLITY DR.
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City | CLYDE
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State | NC
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Zip | 28721-0279
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Country | US
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Telephone | 828-456-5042
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Fax | 828-456-9814
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Provider Business Mailing Address
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Address Line | 35 FACILITY DRIVE
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City | CLYDE
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State | NC
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Zip | 28721-0279
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Country | US
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Telephone | 828-456-5042
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Fax | 828-456-9814
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Authorized Official
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Title or Position | CFO
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Name | WYLEY G WINTERS
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Credential |
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Telephone | 828-631-7000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 2007-01581
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License Number State | NC
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