Organization
REGIONAL EAR NOSE AND THROAT ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROY D CARLSON M.D. (VP)
(856) 778-0559
Entity
Organization
Contact information
Practice address
204 ARK RD, SUITE 102, MOUNT LAUREL, NJ 08054-3100
(856) 778-0559
Mailing address
204 ARK RD, SUITE 102, MOUNT LAUREL, NJ 08054-3100
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3540405
—
NJ
Enumeration date
12/15/2006
Last updated
08/22/2020
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