Individual
ETHAN STAATS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
391 HEATON FOREST RD, CASHIERS, NC 28717
(828) 743-2558
Mailing address
PO BOX 2670, CASHIERS, NC 28717-2670
(828) 743-2558
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
8893
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00060299A
—
GA
01
—
8893
GA STATE BOARD
GA
Enumeration date
09/12/2017
Last updated
09/12/2017
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