Provider Demographics
NPI:1407826662
Name:HAYCOOK, BRIAN E (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:E
Last Name:HAYCOOK
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 1:581 LEROY GEORGE DR STE 380
Mailing Address - Street 2:
Mailing Address - City:CLYDE
Mailing Address - State:NC
Mailing Address - Zip Code:28721-8085
Mailing Address - Country:US
Mailing Address - Phone:828-452-4131
Mailing Address - Fax:828-452-4095
Practice Address - Street 1:581 LEROY GEORGE DR STE 380
Practice Address - Street 2:
Practice Address - City:CLYDE
Practice Address - State:NC
Practice Address - Zip Code:28721-8085
Practice Address - Country:US
Practice Address - Phone:828-452-4131
Practice Address - Fax:828-452-4095
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME87264207X00000X, 207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1174540001OtherDMERC
FL1174540001OtherDMERC CIGNA GOVT SVCS
FL1174540001OtherDMERC CIGNA GOVT SVCS
FL1174540001OtherDMERC