Provider Demographics
NPI:1740451327
Name:HUNTLEY SURGICAL CONSULTING INC
Entity type:Organization
Organization Name:HUNTLEY SURGICAL CONSULTING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE ASST.
Authorized Official - Prefix:
Authorized Official - First Name:JON
Authorized Official - Middle Name:E
Authorized Official - Last Name:HICKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-693-1436
Mailing Address - Street 1:513 N JUSTICE ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28739-4328
Mailing Address - Country:US
Mailing Address - Phone:828-693-1436
Mailing Address - Fax:828-693-1107
Practice Address - Street 1:513 N JUSTICE ST
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28739-4328
Practice Address - Country:US
Practice Address - Phone:828-693-1436
Practice Address - Fax:828-693-1107
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-21
Last Update Date:2010-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9500950261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2337032Medicare PIN
NC1487604302Medicare UPIN