Organization
CHARLOTTE EYE EAR NOSE & THROAT ASSOCIATES, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAG S GILL SCD (CEO)
(704) 295-3000
Entity
Organization
Contact information
Practice address
144 FOUNTAIN PL, MOORESVILLE, NC 28117-0162
(704) 658-0595
(704) 658-0916
Mailing address
6035 FAIRVIEW RD, CHARLOTTE, NC 28210-3256
(704) 295-3000
(704) 295-3468
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
207YS0123X
Facial Plastic Surgery Physician
—
—
231H00000X
Audiologist
—
—
237600000X
Audiologist-Hearing Aid Fitter
—
—
Other
Enumeration date
09/28/2012
Last updated
09/12/2024
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