Provider Demographics
NPI:1245390491
Name:HAUSCHILD, DOUGLAS C (OD)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:C
Last Name:HAUSCHILD
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1620
Mailing Address - Street 2:
Mailing Address - City:WEAVERVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28787-1620
Mailing Address - Country:US
Mailing Address - Phone:828-658-0564
Mailing Address - Fax:828-645-7279
Practice Address - Street 1:40 N. MAIN ST.
Practice Address - Street 2:
Practice Address - City:WEAVERVILLE
Practice Address - State:NC
Practice Address - Zip Code:28787-9427
Practice Address - Country:US
Practice Address - Phone:828-658-0564
Practice Address - Fax:828-645-7279
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2008-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1069152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2270865OtherUNITED HEALTHCARE
NC22946OtherSPECTERA
NC09392OtherNC HEALTH CHOICE
NC8909392Medicaid
NC4928240001OtherCIGNA GOVERNMENT SERVICES
NC09392OtherBLUE CROSS
NC410045707OtherRAILROAD MEDICARE
NCT64935OtherUPIN
NC4928240001OtherCIGNA GOVERNMENT SERVICES
NC09392OtherNC HEALTH CHOICE
NC8909392Medicaid