Provider Demographics
NPI:1235473802
Name:HAYWOOD REGIONAL MEDICAL CENTER
Entity Type:Organization
Organization Name:HAYWOOD REGIONAL MEDICAL CENTER
Other - Org Name:WESTERN CAROLINA ORTHOPAEDIC SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:MCKNIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-452-8210
Mailing Address - Street 1:581 LEROY GEORGE DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CLYDE
Mailing Address - State:NC
Mailing Address - Zip Code:28721-8084
Mailing Address - Country:US
Mailing Address - Phone:828-452-4131
Mailing Address - Fax:828-452-4095
Practice Address - Street 1:581 LEROY GEORGE DR
Practice Address - Street 2:SUITE 300
Practice Address - City:CLYDE
Practice Address - State:NC
Practice Address - Zip Code:28721-8084
Practice Address - Country:US
Practice Address - Phone:828-452-4131
Practice Address - Fax:828-452-4095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-20
Last Update Date:2013-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
No207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Single Specialty
No207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic SurgeryGroup - Single Specialty
No207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle SurgeryGroup - Single Specialty
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC028W4OtherBCBS
NCC786Medicare PIN