Basic Information
Provider Information
NPI: 1952354953
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LETSON
FirstName: AUSTIN
MiddleName: KELLETT
NamePrefix: DR.
NameSuffix: III
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 1209
Address2:  
City: FRANKLIN
State: NC
PostalCode: 287440569
CountryCode: US
TelephoneNumber: 8282131500
FaxNumber: 8286516570
Practice Location
Address1: 111 CENTRAL ST
Address2:  
City: SYLVA
State: NC
PostalCode: 28779
CountryCode: US
TelephoneNumber: 8285866990
FaxNumber: 8285864966
Other Information
ProviderEnumerationDate: 05/18/2006
LastUpdateDate: 07/17/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000X64331NCY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


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