1427508209 NPI number — CAROLINA ORTHOPAEDIC AND NEUROSURGICAL ASSOCIATES

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427508209 NPI number — CAROLINA ORTHOPAEDIC AND NEUROSURGICAL ASSOCIATES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CAROLINA ORTHOPAEDIC AND NEUROSURGICAL ASSOCIATES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1427508209
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/05/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1330 BOILING SPRINGS RD
Provider Second Line Business Mailing Address:
SUITE 1600
Provider Business Mailing Address City Name:
SPARTANBURG
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29303-4201
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
864-582-6396
Provider Business Mailing Address Fax Number:
864-582-1608

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
115 DEACON TILLER CT
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DUNCAN
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29334-8880
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
864-582-6396
Provider Business Practice Location Address Fax Number:
864-582-1608
Provider Enumeration Date:
10/05/2016

Additional Information

Authorized Official

Authorized Official Last Name:
WALCHER
Authorized Official First Name:
KAREN
Authorized Official Middle Name:
D
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
864-582-6396

Provider Taxonomy Codes

  • Taxonomy code: 208100000X , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207X00000X , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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