Organization
RANDOLPH EAR, NOSE & THROAT ASSOCIATES, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES BRANTLEY WEST M.D. (OWNER/PHYSICIAN)
(336) 625-1007
Entity
Organization
Contact information
Practice address
124 N PARK ST, ASHEBORO, NC 27203-5440
(336) 625-1007
(336) 625-0350
Mailing address
124 N PARK ST, ASHEBORO, NC 27203-5440
(336) 625-1007
(336) 625-0350
Taxonomy
Speciality
Code
Description
License number
State
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0254Y
BCBS GROUP PROVIDER #
NC
05
—
890254Y
—
NC
Enumeration date
04/11/2006
Last updated
09/08/2008
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