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NPI Code Detail

MEDICARE: HAWTHORNE EYE ASSOCIATES, P.A.

MEDICARE: HAWTHORNE EYE ASSOCIATES, P.A.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207W00000XOphthalmology Physician78804NC

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12472021OTHERNCMEDICARE GROUP
2CE0337OTHERNCRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
30331COTHERNCBCBS
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1598729147
Entity Type Code : Organization
Provider Name (Legal Business Name) : HAWTHORNE EYE ASSOCIATES, P.A.
Provider Business Mailing Address
First Line : 1364 WESTGATE CENTER DR
Second Line :
City : WINSTON SALEM
State : NC
Zip : 27103-2932
Country : US
Telephone Number : 336-768-4140
Fax Number : 336-768-4487
Provider Business Practice Location Address
First Line : 1364 WESTGATE CENTER DR
Second Line :
City : WINSTON SALEM
State : NC
Zip : 27103-2932
Country : US
Telephone Number : 336-768-4140
Fax Number : 336-768-4487
Authorized Official
Title or Position : PRESIDENT
Name : DR. STEPHEN S NAGY
Credential : M.D.
Telephone Number : 336-768-4140
Provider Enumeration Date : 04/12/2006
Last Update Date : 11/17/2020

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Practice Location Address:
1372 WESTGATE CENTER DR
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1558351726 — ALLERGY PARTNERS, PLLC
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1588654750 — KENT JOSEPH NASTASI M. D.
Practice Location Address:
1372 WESTGATE CENTER DR
WINSTON SALEM, NC
27103-2932
Practice Phone: 336-659-4814
Practice Fax: 336-768-4745
1043200207 — HOLLY MURRELL MCPHERSON M. D.
Practice Location Address:
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WINSTON SALEM, NC
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Practice Fax: 336-768-4745
1184606147 — DR. JOEL MICHAEL HARTMAN MD
Practice Location Address:
1372 WESTGATE CENTER DR
WINSTON SALEM, NC
27103-2932
Practice Phone: 336-659-4814
Practice Fax: 336-768-4745
1306826722 — DR. LAWRENCE H. POTTER JR. MD
Practice Location Address:
1372 WESTGATE CENTER DR
WINSTON SALEM, NC
27103-2932
Practice Phone: 336-659-4814
Practice Fax: 336-768-4745

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