Provider Demographics
NPI:1083915250
Name:SURRY REGIONAL HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:SURRY REGIONAL HEALTH SERVICES, INC.
Other - Org Name:BLUE RIDGE BONE & JOINT CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:HIATT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-719-0011
Mailing Address - Street 1:PO BOX 1267
Mailing Address - Street 2:
Mailing Address - City:MOUNT AIRY
Mailing Address - State:NC
Mailing Address - Zip Code:27030-1267
Mailing Address - Country:US
Mailing Address - Phone:336-786-4522
Mailing Address - Fax:336-789-3025
Practice Address - Street 1:314 S SOUTH ST STE 100
Practice Address - Street 2:
Practice Address - City:MOUNT AIRY
Practice Address - State:NC
Practice Address - Zip Code:27030-4599
Practice Address - Country:US
Practice Address - Phone:336-719-0011
Practice Address - Fax:336-719-0714
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-04
Last Update Date:2014-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
6582080001Medicare NSC
NC2322788Medicare PIN