1700084951 NPI number — HIGH COUNTRY EAR NOSE AND THROAT PLLC

Table of content: ALISA SHEREA HOPKINS RN (NPI 1811404536)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700084951 NPI number — HIGH COUNTRY EAR NOSE AND THROAT PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HIGH COUNTRY EAR NOSE AND THROAT PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1700084951
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/17/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
895 STATE FARM RD
Provider Second Line Business Mailing Address:
STE 303
Provider Business Mailing Address City Name:
BOONE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28607
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-265-4045
Provider Business Mailing Address Fax Number:
825-265-0899

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
895 STATE FARM RD
Provider Second Line Business Practice Location Address:
STE 303
Provider Business Practice Location Address City Name:
BOONE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28607
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-265-4045
Provider Business Practice Location Address Fax Number:
825-265-0899
Provider Enumeration Date:
07/10/2007

Additional Information

Authorized Official

Authorized Official Last Name:
NENOW
Authorized Official First Name:
MARK
Authorized Official Middle Name:
C
Authorized Official Title or Position:
OWNER DOCTOR
Authorized Official Telephone Number:
828-265-4045

Provider Taxonomy Codes

  • Taxonomy code: 207YX0007X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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