Provider Demographics
NPI:1750442927
Name:DOUGLAS C. HAUSCHILD, PLLC
Entity Type:Organization
Organization Name:DOUGLAS C. HAUSCHILD, PLLC
Other - Org Name:WEAVERVILLE EYE ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:C
Authorized Official - Last Name:HAUSCHILD
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:828-658-0564
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2008-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1069152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC044464514OtherVSP
NC410045707OtherRAILROAD MEDICARE
NC09392OtherBLUE CROSS
NC4928240001OtherCIGNA GOVERNMENT SERVICES
NC8909392Medicaid
NC2270865OtherUNITED HEALTHCARE
NCT64935OtherUPIN
NC22946OtherSPECTERA
NC09392OtherNC HEALTH CHOICE
NCDN4281OtherRAILROAD MEDICARE
NC410045707OtherRAILROAD MEDICARE
NC=========OtherEIN
NC2797245BMedicare PIN