1750346516 NPI number — ELIZABETH D. WESTLY M.D.

Table of content: (NPI 1063553956)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750346516 NPI number — ELIZABETH D. WESTLY M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WESTLY
Provider First Name:
ELIZABETH
Provider Middle Name:
D.
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

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:
1750346516
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/16/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1689
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ETOWAH
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28729-1689
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-891-5524
Provider Business Mailing Address Fax Number:
828-891-4069

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2161 HENDERSONVILLE RD
Provider Second Line Business Practice Location Address:
STE C
Provider Business Practice Location Address City Name:
ARDEN
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28704-7741
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-684-1875
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207N00000X , with the licence number:  39228 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 8986666 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




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