# EAR NOSE THROAT AND AUDIOLOGY ASSOCIATES

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

## Provider details

- **NPI number:** 1902043185
- **Authorized official:** LEROY BROADNAX (OFFICE MANAGER)
- **Authorized official phone:** (704) 544-6533

## Contact information

- **Practice address:** 327 W SOUTH ST, UNION, SC 29379-2838
- **Practice address phone:** (864) 429-0115
- **Practice address fax:** (864) 429-0271
- **Mailing address:** 8318 PINEVILLE MATTHEWS RD, SUITE 708-151, CHARLOTTE, NC 28226-4753
- **Mailing address phone:** (704) 544-6533
- **Mailing address fax:** (704) 544-6583

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207YX0007X | Plastic Surgery within the Head & Neck (Otolaryngology) Physician | — | NULL | Yes |
| 207YX0007X | Plastic Surgery within the Head & Neck (Otolaryngology) Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/09/2009
- **Last updated:** 01/09/2009