Provider Demographics
NPI:1023124575
Name:HAZELWOOD FAMILY MEDICINE, PLLC
Entity type:Organization
Organization Name:HAZELWOOD FAMILY MEDICINE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE SECRETARY
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:ARRINGTON
Authorized Official - Last Name:RICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-456-2828
Mailing Address - Street 1:1088 BROWN AVE
Mailing Address - Street 2:
Mailing Address - City:WAYNESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28786-1918
Mailing Address - Country:US
Mailing Address - Phone:828-456-2828
Mailing Address - Fax:828-456-8903
Practice Address - Street 1:1088 BROWN AVE
Practice Address - Street 2:
Practice Address - City:WAYNESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28786-1918
Practice Address - Country:US
Practice Address - Phone:828-456-2828
Practice Address - Fax:828-456-8903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC012KKOtherBCBS OF NC
NC89012KKMedicaid
NC012KKOtherBCBS OF NC
NC=========OtherCIGNA
NC=========OtherCIGNA