Organization
CAROLINA ORTHOPAEDIC & SPORTS MEDICINE CENTER PA
Active
Organization
CAROLINA ORTHOPAEDIC & SPORTS MEDICINE CENTER PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HENRY THOMASON (MD)
(704) 865-0077
Entity
Organization
Contact information
Practice address
2345 COURT DRIVE, GASTONIA, NC 28054-2151
(704) 865-0077
(704) 867-6401
Mailing address
2345 COURT DRIVE, GASTONIA, NC 28054-2151
(704) 865-0077
(704) 867-6401
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
207XS0106X
Orthopaedic Hand Surgery Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2322421
MEDICARE GROUP
NC
05
—
89098L
—
NC
Enumeration date
05/08/2006
Last updated
06/17/2025
Update your record
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