Provider Demographics
NPI:1205088796
Name:ST LUKES PHYSICIAN NETWORK INC
Entity type:Organization
Organization Name:ST LUKES PHYSICIAN NETWORK INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:C
Authorized Official - Last Name:HIGHSMITH
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:828-894-3311
Mailing Address - Street 1:PO BOX 505
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:NC
Mailing Address - Zip Code:28722-0505
Mailing Address - Country:US
Mailing Address - Phone:828-894-3311
Mailing Address - Fax:
Practice Address - Street 1:101 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:NC
Practice Address - Zip Code:28722-6418
Practice Address - Country:US
Practice Address - Phone:828-894-3311
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST LUKES HOSPITAL INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-10-16
Last Update Date:2008-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty