Basic Information
| Provider Information | |||||||||
| NPI: | 1821503947 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CARTERET SURGICAL ASSOCIATES P.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3714 GUARDIAN AVE STE E | ||||||||
| Address2: | |||||||||
| City: | MOREHEAD CITY | ||||||||
| State: | NC | ||||||||
| PostalCode: | 285572975 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2522225862 | ||||||||
| FaxNumber: | 2522479469 | ||||||||
| Practice Location | |||||||||
| Address1: | 3700 SYMI CIR | ||||||||
| Address2: | |||||||||
| City: | MOREHEAD CITY | ||||||||
| State: | NC | ||||||||
| PostalCode: | 285574309 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2522225888 | ||||||||
| FaxNumber: | 2527730506 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/12/2017 | ||||||||
| LastUpdateDate: | 12/12/2017 | ||||||||
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| AuthorizedOfficialLastName: | WATSON | ||||||||
| AuthorizedOfficialFirstName: | ROBERT | ||||||||
| AuthorizedOfficialMiddleName: | JACOB | ||||||||
| AuthorizedOfficialTitleorPosition: | CREDENTIALIST | ||||||||
| AuthorizedOfficialTelephone: | 2522225862 | ||||||||
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| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | CARTERET SURGICAL ASSOCIATES P.A. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208200000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Plastic Surgery |
No ID Information.