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General NPI Number Information
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NPI Number | 1881681856
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Entity Type | Organization
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Legal Business Name | TATE CLINIC PA
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Dates
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Enumeration Date | 10/04/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 436 HOSPITAL DR STE 200
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City | LINVILLE
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State | NC
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Zip | 28646
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Country | US
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Telephone | 828-737-7917
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Fax | 828-737-6869
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Provider Business Mailing Address
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Address Line | PO BOX 843
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City | LINVILLE
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State | NC
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Zip | 28646-0843
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Country | US
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Telephone | 828-737-7917
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Fax | 828-737-6869
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Authorized Official
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Title or Position | OWNER PRESIDENT
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Name | MR. WILLIAM C TATE II
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Credential | MD
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Telephone | 828-737-7917
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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