1417900440 NPI number — DR. HUGH WILLIAM HURST D.C.

Table of content: DR. HUGH WILLIAM HURST D.C. (NPI 1417900440)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417900440 NPI number — DR. HUGH WILLIAM HURST D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HURST
Provider First Name:
HUGH
Provider Middle Name:
WILLIAM
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.C.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1417900440
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/12/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
121 W COUNCIL ST
Provider Second Line Business Mailing Address:
STE. 306
Provider Business Mailing Address City Name:
SALISBURY
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28144-4357
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
704-636-7528
Provider Business Mailing Address Fax Number:
704-636-6070

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
121 W COUNCIL ST
Provider Second Line Business Practice Location Address:
STE. 306
Provider Business Practice Location Address City Name:
SALISBURY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28144-4357
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-636-7528
Provider Business Practice Location Address Fax Number:
704-636-6070
Provider Enumeration Date:
05/19/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  NC 1626 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0845B . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 890845B , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00205693 . This is a "PALMETTO GBA" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".




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