Organization
HIDA CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EMILY JANE TATUM MD (SOLE ORGANIZER)
(828) 644-5573
Entity
Organization
Contact information
Practice address
1939 SHOAL CREEK RD, MURPHY, NC 28906-8480
(828) 644-5573
(828) 644-5562
Mailing address
1939 SHOAL CREEK RD, MURPHY, NC 28906-8480
(828) 494-7157
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
2007-00088
NC
Other
Enumeration date
01/03/2008
Last updated
09/22/2010
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