Basic Information
| Provider Information | |||||||||
| NPI: | 1932771466 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SMOKY MOUNTAIN URGENT CARE PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2029 | ||||||||
| Address2: | |||||||||
| City: | BRYSON CITY | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287135029 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8285384546 | ||||||||
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| Practice Location | |||||||||
| Address1: | 21 S MAIN ST | ||||||||
| Address2: | |||||||||
| City: | ROBBINSVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287719054 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8284797682 | ||||||||
| FaxNumber: | 8284797683 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/14/2021 | ||||||||
| LastUpdateDate: | 07/14/2021 | ||||||||
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| AuthorizedOfficialLastName: | CASTOR | ||||||||
| AuthorizedOfficialFirstName: | DAVID | ||||||||
| AuthorizedOfficialMiddleName: | RANDALL | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8285384546 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 07/14/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR1300X | Y | Ambulatory Health Care Facilities | Clinic/Center | Rural Health |
No ID Information.