Provider Demographics
NPI:1295715258
Name:BURLINGTON SURGICAL ASSOCIATES PA
Entity type:Organization
Organization Name:BURLINGTON SURGICAL ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:HADLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-538-1900
Mailing Address - Street 1:1236 HUFFMAN MILL RD
Mailing Address - Street 2:1500 MEDICAL ARTS CTR
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215
Mailing Address - Country:US
Mailing Address - Phone:336-538-1900
Mailing Address - Fax:336-538-1989
Practice Address - Street 1:1236 HUFFMAN MILL RD
Practice Address - Street 2:1500 MEDICAL ARTS CTR
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215
Practice Address - Country:US
Practice Address - Phone:336-538-1900
Practice Address - Fax:336-538-1989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-18
Last Update Date:2010-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890115KMedicaid
NC0974620001Medicare NSC
NC2308726Medicare ID - Type Unspecified