Organization
PRIME DOC OF HAYWOOD, PA
Active
Organization
PRIME DOC OF HAYWOOD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TALBOT G. MCCORMICK III MD (PRESIDENT)
(678) 441-8500
Entity
Organization
Contact information
Practice address
262 LEROY GEORGE DRIVE, CLYDE, NC 28721-7430
(828) 452-8862
(843) 237-5073
Mailing address
5901-C PEACHTREE DUNWOODY ROAD, SUITE 350, ATLANTA, GA 30328-7159
(678) 441-8556
(678) 441-8656
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
013PU
BLUE CROSS BLUE SHIELD
NC
05
—
89013PU
—
NC
01
—
DC9720
RAILROAD MEDICARE
NC
Enumeration date
04/21/2006
Last updated
07/10/2015
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