Healthcare Provider Details

I. General information

NPI: 1003112541
Provider Name (Legal Business Name): HAYWOOD REGIONAL MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2011
Last Update Date: 11/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 BRETTWOOD TRCE
CLYDE NC
28721-8021
US

IV. Provider business mailing address

40 BRETTWOOD TRCE
CLYDE NC
28721-8021
US

V. Phone/Fax

Practice location:
  • Phone: 828-456-8633
  • Fax: 828-452-9225
Mailing address:
  • Phone: 828-456-8633
  • Fax: 828-452-9225

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

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