Organization
SMOKY MOUNTAIN UROLOGICAL INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUSTAN JOEL VAN WYK D.O. (PROVIDER)
(828) 698-0896
Entity
Organization
Contact information
Practice address
1334 ASHEVILLE HWY, HENDERSONVILLE, NC 28791-3414
(828) 698-0896
(828) 698-9532
Mailing address
1334 ASHEVILLE HWY, HENDERSONVILLE, NC 28791-3414
(828) 698-0896
(828) 698-9532
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
200001545
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89128F6
—
NC
Enumeration date
05/14/2007
Last updated
09/26/2011
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