Provider Demographics
NPI:1992708135
Name:HAGUEWOOD, BILLY J JR (MD)
Entity type:Individual
Prefix:DR
First Name:BILLY
Middle Name:J
Last Name:HAGUEWOOD
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:479 HEYWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29307
Mailing Address - Country:US
Mailing Address - Phone:864-583-6381
Mailing Address - Fax:864-583-6390
Practice Address - Street 1:1520 BOILING SPRINGS RD
Practice Address - Street 2:
Practice Address - City:BOILING SPRINGS
Practice Address - State:SC
Practice Address - Zip Code:29316
Practice Address - Country:US
Practice Address - Phone:864-583-6381
Practice Address - Fax:864-583-6390
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2019-07-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
SC023134207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCT73710Medicaid
SC180044682OtherRAILROAD MEDICARE INDIVID
SCCJ6730OtherRAILROAD MEDICARE GROUP
SC790656VOtherNORTH CAROLINA MEDICAID
SCH607977292Medicare PIN
SCH60797Medicare UPIN