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General NPI Number Information
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NPI Number | 1710937958
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Entity Type | Organization
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Legal Business Name | MOUNTAIN PATHOLOGY SERVICES PA
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Dates
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Enumeration Date | 05/10/2006
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Last Update Date | 06/12/2013
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Provider Practice Location Address
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Address Line | 68 HOSPITAL RD
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City | SYLVA
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State | NC
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Zip | 28779-2722
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Country | US
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Telephone | 828-586-7114
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 409
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City | BLUEFIELD
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State | WV
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Zip | 24701-0409
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. WILLIAM LAWRENCE SELBY
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Credential | MD
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Telephone | 828-586-7114
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number |
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License Number State |
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