Provider Demographics
NPI:1285688481
Name:MOUNTAIN FAMILY MEDICINE
Entity Type:Organization
Organization Name:MOUNTAIN FAMILY MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:ZUBER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:828-262-1800
Mailing Address - Street 1:245 WINKLERS CREEK RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-7838
Mailing Address - Country:US
Mailing Address - Phone:828-262-1800
Mailing Address - Fax:828-262-5444
Practice Address - Street 1:245 WINKLERS CREEK ROAD
Practice Address - Street 2:SUITE C
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-7838
Practice Address - Country:US
Practice Address - Phone:828-262-1800
Practice Address - Fax:828-262-5444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCBZ0231213261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89016F1Medicaid
NCC87360Medicare UPIN
NC2335686Medicare ID - Type Unspecified
NC6082500001Medicare NSC