Provider Demographics
NPI:1518158559
Name:HEDGECOCK, SUZANN B (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:SUZANN
Middle Name:B
Last Name:HEDGECOCK
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:4510 PREMIER DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27265-8349
Mailing Address - Country:US
Mailing Address - Phone:336-878-6644
Mailing Address - Fax:336-878-6645
Practice Address - Street 1:4510 PREMIER DR
Practice Address - Street 2:STE 102
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265-8349
Practice Address - Country:US
Practice Address - Phone:336-878-6644
Practice Address - Fax:336-878-6645
Is Sole Proprietor?:No
Enumeration Date:2007-08-06
Last Update Date:2015-02-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC100861363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
S70970Medicare UPIN