Basic Information
| Provider Information | |||||||||
| NPI: | 1679895759 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CAROLINA SPINE & NEUROSURGERY CENTER PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 25370 | ||||||||
| Address2: | |||||||||
| City: | ASHEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 288131370 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8282557776 | ||||||||
| FaxNumber: | 8282745134 | ||||||||
| Practice Location | |||||||||
| Address1: | 129 HOSPITAL DRIVE | ||||||||
| Address2: | |||||||||
| City: | SPRUCE PINE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287773035 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8282557776 | ||||||||
| FaxNumber: | 8282745134 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/17/2010 | ||||||||
| LastUpdateDate: | 11/29/2010 | ||||||||
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| AuthorizedOfficialLastName: | FLEMING | ||||||||
| AuthorizedOfficialFirstName: | KEVIN | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 8282557776 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084N0400X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology | 207T00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Neurological Surgery |
No ID Information.