Provider Demographics
NPI:1538457114
Name:ENGLAND, BOBBY FLAY (MD)
Entity type:Individual
Prefix:DR
First Name:BOBBY
Middle Name:FLAY
Last Name:ENGLAND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 ENGLAND DR
Mailing Address - Street 2:
Mailing Address - City:ELLENBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28040-7644
Mailing Address - Country:US
Mailing Address - Phone:828-453-8807
Mailing Address - Fax:828-453-8807
Practice Address - Street 1:140 ENGLAND DR
Practice Address - Street 2:
Practice Address - City:ELLENBORO
Practice Address - State:NC
Practice Address - Zip Code:28040-7644
Practice Address - Country:US
Practice Address - Phone:828-453-8807
Practice Address - Fax:828-453-8807
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-15
Last Update Date:2011-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13978207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCC 79953Medicare PIN