Organization Name: | VISTA FAMILY HEALTH PA |
NPI Number: | 1245317130 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ROBERT WILLIAM FIELDS (PRESIDENT) |
Mailing Address: | 2585 Hendersonville Rd Suite C Arden |
State: | NC US |
Postal Code: | 287049577 |
Phone Number: | 8286878647 |
Fax Number: | 8286846891 |
NPI Enumeration Date: | 11/01/2006 |
NPI Last Update Date: | 04/29/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 200101201 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |