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General NPI Number Information
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NPI Number | 1598235830
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Entity Type | Organization
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Legal Business Name | MISSION COMMUNITY ANESTHESIOLOGY SPECIALISTS LLC
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Dates
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Enumeration Date | 11/29/2018
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Last Update Date | 11/30/2018
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Provider Practice Location Address
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Address Line | 89 HOSPITAL DR STE C
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City | BREVARD
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State | NC
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Zip | 28712-4838
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Country | US
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Telephone | 828-213-1740
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 603366
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City | CHARLOTTE
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State | NC
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Zip | 28260-3366
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Country | US
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Telephone |
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Fax | 828-681-1575
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Authorized Official
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Title or Position | PROVIDER ENROLLMENT SPECIALIST
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Name | CAROL HILL
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Credential |
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Telephone | 828-651-6579
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2084P2900X
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Taxonomy Name | Pain Medicine (Psychiatry & Neurology) Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number |
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License Number State |
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