# EAR NOSE THROAT & AUDIOLOGY ASSOCIATES

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** EAR NOSE THROAT & AUDIOLOGY ASSOCIATES OF THE CAROLINAS, P.A.
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1366632655
- **Legal business name:** EAR NOSE THROAT & AUDIOLOGY ASSOCIATES OF THE CAROLINAS, P.A.
- **Authorized official:** MR. LEROY BROADNAX (OFFICE MANAGER)
- **Authorized official phone:** (803) 328-3686

## Contact information

- **Practice address:** 744 ARDEN LN, SUITE 200, ROCK HILL, SC 29732-2984
- **Practice address phone:** (803) 328-3686
- **Practice address fax:** (803) 328-9889
- **Mailing address:** 8334 PINEVILLE MATTHEWS RD, SUITE 103-151, CHARLOTTE, NC 28226-3774
- **Mailing address phone:** (803) 328-3686
- **Mailing address fax:** (803) 328-9889

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Y00000X | Otolaryngology Physician | — | NULL | Yes |
| 207Y00000X | Otolaryngology Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/01/2007
- **Last updated:** 08/14/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | GP4146 | — | SC |