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Organization

HICKORY SURGICAL CLINIC, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. MICHELE F HAYNES (PRACTICE ADMINISTRATOR)
(828) 327-9178
Entity
Organization

Contact information

Practice address
415 N CENTER ST, SUITE 102, HICKORY, NC 28601-5036
(828) 327-9178
(828) 304-0202
Mailing address
415 N CENTER ST, SUITE 102, HICKORY, NC 28601-5036
(828) 327-9178
(828) 304-0202

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
39117
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01779
BLUE CROSS BLUE SHIELD NC
NC
05
8901779
NC
01
CD2324
RAIL ROAD MEDICARE
NC
Enumeration date
04/09/2006
Last updated
04/14/2010
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