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Organization
EAR NOSE THROAT & AUDIOLOGY ASSOCIATES
Active
Organization
EAR NOSE THROAT & AUDIOLOGY ASSOCIATES
Active
Parent organization
EAR NOSE THROAT & AUDIOLOGY ASSOCIATES OF THE CAROLINAS, P.A.
Organization subpart
Yes
Provider details
NPI number
Legal business name
EAR NOSE THROAT & AUDIOLOGY ASSOCIATES OF THE CAROLINAS, P.A.
Authorized official
MR. LEROY BROADNAX (OFFICE MANAGER)
(803) 328-3686
Entity
Organization
Contact information
Practice address
744 ARDEN LN, SUITE 200, ROCK HILL, SC 29732-2984
(803) 328-3686
(803) 328-9889
Mailing address
8334 PINEVILLE MATTHEWS RD, SUITE 103-151, CHARLOTTE, NC 28226-3774
(803) 328-3686
(803) 328-9889
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
NULL
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP4146
—
SC
Enumeration date
08/01/2007
Last updated
08/14/2015
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