# NORTH CAROLINA EYE EAR NOSE & THROAT PA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** North Carolina Eye Ear Nose & Throat of Roxboro
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861583700
- **Authorized official:** JENNIFER L WHITEHEAD (CREDENTIALING COORDINATOR)
- **Authorized official phone:** (919) 595-2143

## Contact information

- **Practice address:** 911 RIDGE RD STE A, ROXBORO, NC 27573-4574
- **Practice address phone:** (336) 597-2826
- **Practice address fax:** (336) 597-2626
- **Mailing address:** 4102 N ROXBORO ST, DURHAM, NC 27704-2122
- **Mailing address phone:** (919) 595-2000
- **Mailing address fax:** (919) 595-2143

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | — | NULL | — |
| 207W00000X | Ophthalmology Physician | — | — | — |
| 207Y00000X | Otolaryngology Physician | — | NULL | Yes |
| 207Y00000X | Otolaryngology Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/27/2006
- **Last updated:** 09/11/2025