=====================================================
General NPI Number Information
=====================================================
NPI Number | 1558335729
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ALLEN BRUCE GILPIN M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/15/2006
-----------------------------------------------------
Last Update Date | 09/04/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1278 HENDERSONVILLE RD STE B
-----------------------------------------------------
City | ASHEVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28803-1954
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 828-450-1453
-----------------------------------------------------
Fax | 828-412-5046
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 36
-----------------------------------------------------
City | NAPLES
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28760-0036
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 828-450-1453
-----------------------------------------------------
Fax | 828-412-5046
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084A0401X
-----------------------------------------------------
Taxonomy Name | Addiction Medicine (Psychiatry & Neurology) Physician
-----------------------------------------------------
License Number | 36713
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | 36713
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------