Organization
NORTHEAST SURGICAL SPECIALTIES, LLC
Active
Parent organization
NORTHEAST SURGICAL SPECIALTIES, LLC
Other names
Piedmont Orthopedic Specialists
Organization subpart
Yes
Provider details
NPI number
Legal business name
NORTHEAST SURGICAL SPECIALTIES, LLC
Authorized official
THOMAS F LAYMON (SR VP)
(704) 403-2276
Entity
Organization
Contact information
Practice address
1090 NORTHEAST GATEWAY COURT NE, SUITE 204, CONCORD, NC 28025-2440
(704) 403-7020
(704) 403-7039
Mailing address
1090 NORTHEAST GATEWAY COURT NE, SUITE 204, CONCORD, NC 28025-2440
(704) 403-7020
(704) 403-7039
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
018W5
BCBS
NC
05
—
5906976
—
NC
01
—
DO1210
RAILROAD MEDICARE PTAN
NC
Enumeration date
12/11/2006
Last updated
01/26/2016
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