Provider Demographics
NPI:1164567145
Name:BROADHURST, RICHARD SMOTHERS (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:SMOTHERS
Last Name:BROADHURST
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1200 RIDGEFIELD BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28806-2253
Mailing Address - Country:US
Mailing Address - Phone:828-670-7474
Mailing Address - Fax:828-670-7472
Practice Address - Street 1:1200 RIDGEFIELD BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28806-2253
Practice Address - Country:US
Practice Address - Phone:828-670-7474
Practice Address - Fax:828-670-7472
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC98016042083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCG88422Medicare UPIN