Basic Information
| Provider Information | |||||||||
| NPI: | 1093815755 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HARTYE | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | KILCOYNE | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 60 CALEDONIA RD | ||||||||
| Address2: | APT 105 | ||||||||
| City: | ASHEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 288030900 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5027748631 | ||||||||
| FaxNumber: | 8286811575 | ||||||||
| Practice Location | |||||||||
| Address1: | 60 CALEDONIA RD | ||||||||
| Address2: | APT 105 | ||||||||
| City: | ASHEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 288030900 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5027748631 | ||||||||
| FaxNumber: | 8286811575 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/23/2006 | ||||||||
| LastUpdateDate: | 05/01/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 23029 | NC | Y | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 45792 | KY | N | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 14943 | 01 | WELLPATH | OTHER | 40350 | 01 | BLUE CROSS BLUE SHIELD | OTHER | 80088139 | 01 | RAILROAD MEDICARE | OTHER | 1406859 | 01 | UNITED HEALTH CARE | OTHER | 20177 | 01 | CIGNA | OTHER | 207087C | 01 | NC | MEDICARE PTAN | OTHER | 8940350 | 05 | NC | MEDICAID |