Provider Demographics
NPI:1598194284
Name:PARK HILL MEDICINE, PA
Entity Type:Organization
Organization Name:PARK HILL MEDICINE, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADM
Authorized Official - Prefix:MS
Authorized Official - First Name:BONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WOOTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-697-1177
Mailing Address - Street 1:510 PARK HILL COURT
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28739-4265
Mailing Address - Country:US
Mailing Address - Phone:828-697-1177
Mailing Address - Fax:
Practice Address - Street 1:510 PARK HILL COURT
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28739-4265
Practice Address - Country:US
Practice Address - Phone:828-697-1177
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-04
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty