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Organization

MOUNTAIN MEDICAL ARTS PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KELLY SUE ROTHE D.O. (PHYSICIAN)
(828) 678-9352
Entity
Organization

Contact information

Practice address
2 S MAIN ST, BURNSVILLE, NC 28714-2929
(828) 678-9352
(828) 682-7866
Mailing address
PO BOX 1240, BURNSVILLE, NC 28714-1240
(828) 678-9352
(828) 682-7866

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
NC200301048
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
135R4
BLUE CROSS BLUE SHEILD
NC
05
89135R4
NC
01
NC200301048
STATE LICENCE #
NC
01
P00252272
PERSONAL MEDICARE #
NC
Enumeration date
01/18/2006
Last updated
03/07/2023
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