Basic Information
| Provider Information | |||||||||
| NPI: | 1699703678 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WEBB | ||||||||
| FirstName: | BOB | ||||||||
| MiddleName: | LEE | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 571 S ALLEN RD | ||||||||
| Address2: | |||||||||
| City: | FLAT ROCK | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287319447 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8286926178 | ||||||||
| FaxNumber: | 8553563998 | ||||||||
| Practice Location | |||||||||
| Address1: | 510 BALSAM RD | ||||||||
| Address2: | |||||||||
| City: | HENDERSONVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287925703 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8286934431 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/29/2006 | ||||||||
| LastUpdateDate: | 08/13/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 35224 | NC | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 8986244 | 05 | NC | MEDICAID | 2198204C | 01 | NC | MEDICARE PTAN | OTHER | 86244 | 01 | NC | BCBS ID# | OTHER |