# RALEIGH CAPITOL EAR, NOSE, AND THROAT

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

## Provider details

- **NPI number:** 1902170442
- **Authorized official:** JENNY C BEAL COPM (BILLING MANAGER)
- **Authorized official phone:** (919) 809-8140

## Contact information

- **Practice address:** 4600 LAKE BOONE TRL, RALEIGH, NC 27607-7528
- **Practice address phone:** (919) 787-1374
- **Practice address fax:** (919) 420-2028
- **Mailing address:** 4600 LAKE BOONE TRL, RALEIGH, NC 27607-7528
- **Mailing address phone:** (919) 787-1374
- **Mailing address fax:** (919) 571-8135

## Taxonomy

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

## Other

- **Enumeration date:** 03/01/2012
- **Last updated:** 05/04/2026