Basic Information
| Provider Information | |||||||||
| NPI: | 1386752095 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CAROLINA EAR, NOSE & THROAT HEAD AND NECK SURGERY CENTER, P.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 256C 10TH AVE NE | ||||||||
| Address2: | |||||||||
| City: | HICKORY | ||||||||
| State: | NC | ||||||||
| PostalCode: | 286013832 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8283222183 | ||||||||
| FaxNumber: | 8283284526 | ||||||||
| Practice Location | |||||||||
| Address1: | 135 S SHARON AMITY RD | ||||||||
| Address2: | SUITE 208 | ||||||||
| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282112842 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7043423402 | ||||||||
| FaxNumber: | 7043666580 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/25/2006 | ||||||||
| LastUpdateDate: | 03/29/2011 | ||||||||
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| AuthorizedOfficialLastName: | HARRILL | ||||||||
| AuthorizedOfficialFirstName: | WILLARD | ||||||||
| AuthorizedOfficialMiddleName: | CARDWELL | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 7043423402 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332S00000X | Y | Suppliers | Hearing Aid Equipment |
No ID Information.