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General NPI Number Information
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NPI Number | 1568442242
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Entity Type | Individual
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Provider Name | BRUCE KENNETH BACOT M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/19/2006
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Last Update Date | 05/16/2011
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Provider Practice Location Address
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Address Line | 11 VANDERBILT PARK DR
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City | ASHEVILLE
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State | NC
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Zip | 28803-1700
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Country | US
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Telephone | 828-213-1740
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Fax | 828-213-1742
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Provider Business Mailing Address
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Address Line | PO BOX 15268
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City | ASHEVILLE
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State | NC
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Zip | 28813-0268
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Country | US
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Telephone | 828-250-2833
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Fax | 828-665-8275
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0214X
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Taxonomy Name | Pediatric Pulmonology Physician
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License Number | 9701689
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 2080P0201X
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Taxonomy Name | Pediatric Allergy/Immunology Physician
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License Number | 9701689
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License Number State | NC
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