Randall Provost, MD | |
98 Doctors Dr, Suite 200, Sylva, NC 28779-4501 | |
(828) 586-8971 | |
(828) 586-4083 |
Full Name | Randall Provost |
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Gender | Male |
Speciality | Internal Medicine |
Location | 98 Doctors Dr, Sylva, North Carolina |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1003873456 | NPI | - | NPPES |
7969355 | Medicaid | NC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 32835 (North Carolina) | Primary |
Entity Name | Dlp Western Carolina Physician Practices Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1609281641 PECOS PAC ID: 9032338975 Enrollment ID: O20140908002531 |
Mailing Address | Practice Location Address |
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Randall Provost, MD 98 Doctors Dr, Ste 200, Sylva, NC 28779-4501 Ph: (828) 586-8971 | Randall Provost, MD 98 Doctors Dr, Suite 200, Sylva, NC 28779-4501 Ph: (828) 586-8971 |
Dr. Joshua Douglas Patton, DO Internal Medicine Medicare: Medicare Enrolled Practice Location: 80 Healthcare Dr Ste 203, Sylva, NC 28779 Phone: 828-586-5531 | |
Maria Garcia Moore, M.D. Internal Medicine Medicare: Medicare Enrolled Practice Location: 141 Willets Rd, Sylva, NC 28779 Phone: 828-243-1999 | |
David S Thomas, MD PA Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 14 Medical Park Loop, Sylva, NC 28779 Phone: 828-586-7610 Fax: 828-586-7615 | |
Philip Arlis Neiheisel, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 132 Sylva Plz, Sylva, NC 28779 Phone: 828-586-2377 Fax: 828-586-5888 | |
Jodi Balderrama, Internal Medicine Medicare: Medicare Enrolled Practice Location: 98 Cope Creek Rd, Sylva, NC 28779 Phone: 706-982-9641 | |
Mr. David R Dennison, MD Internal Medicine Medicare: Medicare Enrolled Practice Location: 68 Hospital Rd, Sylva, NC 28779 Phone: 828-586-7428 Fax: 828-586-7427 |