Organization
PINEHURST SURGICAL CLINIC, PA
Active
Parent organization
PINEHURST SURGICAL CLINIC PA
Other names
Pinehurst Surgical Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
PINEHURST SURGICAL CLINIC PA
Authorized official
KATIE RICHARDSON HEFFNER (CREDENTIALING COORDINATOR)
(910) 235-2711
Entity
Organization
Contact information
Practice address
3716 MORGANTON RD, FAYETTEVILLE, NC 28303-4963
(910) 302-8026
(910) 420-1988
Mailing address
PO BOX 2000, PINEHURST, NC 28374-2000
(910) 295-6831
(910) 295-0244
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
890297E
—
NC
Enumeration date
09/13/2022
Last updated
09/13/2022
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