Provider Demographics
NPI:1003112541
Name:HAYWOOD REGIONAL MEDICAL CENTER
Entity Type:Organization
Organization Name:HAYWOOD REGIONAL MEDICAL CENTER
Other - Org Name:HAYWOOD SURGICAL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:MCKNIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-452-8210
Mailing Address - Street 1:40 BRETTWOOD TRCE
Mailing Address - Street 2:
Mailing Address - City:CLYDE
Mailing Address - State:NC
Mailing Address - Zip Code:28721-8021
Mailing Address - Country:US
Mailing Address - Phone:828-456-8633
Mailing Address - Fax:828-452-9225
Practice Address - Street 1:40 BRETTWOOD TRCE
Practice Address - Street 2:
Practice Address - City:CLYDE
Practice Address - State:NC
Practice Address - Zip Code:28721-8021
Practice Address - Country:US
Practice Address - Phone:828-456-8633
Practice Address - Fax:828-452-9225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-01
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5917421Medicaid
NC235054FMedicare PIN