Provider Demographics
NPI:1538118682
Name:MEDICAL HEIGHTS OB-GYN, PA
Entity Type:Organization
Organization Name:MEDICAL HEIGHTS OB-GYN, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:HOWARD
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:828-437-4488
Mailing Address - Street 1:309 S COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655-3844
Mailing Address - Country:US
Mailing Address - Phone:828-437-4488
Mailing Address - Fax:828-438-1025
Practice Address - Street 1:309 S COLLEGE ST
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-3844
Practice Address - Country:US
Practice Address - Phone:828-437-4488
Practice Address - Fax:828-438-1025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-08
Last Update Date:2011-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0741251OtherUNITED HEALTHCARE
NC1145YOtherBLUE CROSS AND BLUE SHIELD OF NC
NC890213MMedicaid
NC0213MOtherBLUE CROSS AND BLUE SHIELD OF NC
NC891145YMedicaid
NC890213MMedicaid
NC2315894Medicare PIN
NC2253891Medicare PIN