# CHARLOTTE EYE EAR NOSE & THROAT ASSOCIATES, PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1659778579
- **Authorized official:** DR. JAG S GILL SCD (CEO)
- **Authorized official phone:** (704) 295-3000

## Contact information

- **Practice address:** 838 W MEETING ST, SUITE C, LANCASTER, SC 29720-6233
- **Practice address phone:** (803) 286-8626
- **Practice address fax:** (803) 286-9924
- **Mailing address:** 6035 FAIRVIEW RD, CHARLOTTE, NC 28210-3256
- **Mailing address phone:** (704) 295-3000

## Taxonomy

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

## Other

- **Enumeration date:** 11/20/2014
- **Last updated:** 11/20/2014