Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0201X | Pediatric Allergist | 9701689 | NC |
Y | 2080P0214X | Pediatric Pulmonologist | 9701689 | NC |
NPI | 1568442242 |
---|---|
Provider Name | Bruce Kenneth Bacot |
First Address | Asheville, NC 28813-0268 |
Second Address | Asheville, NC 28803-1700 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/01/2006 |
Last Update Date | 16/05/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
89127MM | (05) | NC |
G06749 | (02) |