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Organization

GREENVILLE SURGICAL, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BARRY RUSSELL HASTINGS M.D. (OWNER/PHYSICIAN)
(252) 754-8370
Entity
Organization

Contact information

Practice address
1011 W H SMITH BLVD, SUITE 100, GREENVILLE, NC 27834-3787
(252) 754-8370
(252) 754-8387
Mailing address
1011 W H SMITH BLVD, SUITE 100, GREENVILLE, NC 27834-3787
(252) 754-8370
(252) 754-8387

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
9800894
NC
2086S0129X
Vascular Surgery Physician
9800894
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
891149V
NC
Enumeration date
11/08/2007
Last updated
10/29/2010
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