Healthcare Provider Details

I. General information

NPI: 1023311560
Provider Name (Legal Business Name): HAYWOOD REGIONAL MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2010
Last Update Date: 11/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

262 LEROY GEORGE DR
CLYDE NC
28721-7430
US

IV. Provider business mailing address

262 LEROY GEORGE DR
CLYDE NC
28721-7430
US

V. Phone/Fax

Practice location:
  • Phone: 828-452-8691
  • Fax: 828-452-8393
Mailing address:
  • Phone: 828-452-8691
  • Fax: 828-452-8393

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number
License Number StateNC

VIII. Authorized Official

Name: MR. MICHAEL DAVID MCKNIGHT
Title or Position: CFO
Credential:
Phone: 828-452-8210