Organization
CAROLINAS MEDICAL CENTER
Active
Parent organization
CAROLINAS MEDICAL CENTER
Other names
Carolinas Back & Sports Specialists
Organization subpart
Yes
Provider details
NPI number
Legal business name
CAROLINAS MEDICAL CENTER
Authorized official
MR. THOMAS FORD LAYMON (SVP)
(704) 631-0002
Entity
Organization
Contact information
Practice address
3030 RANDOLPH ROAD, SUITE 105, CHARLOTTE, NC 28211-1365
(704) 512-4400
(704) 512-4401
Mailing address
PO BOX 601372, CHARLOTTE, NC 28260-1372
(704) 512-4400
(704) 512-4401
Taxonomy
Speciality
Code
Description
License number
State
2081P0004X
Spinal Cord Injury Medicine Physician
—
—
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5903972
—
NC
05
—
NPB197
—
SC
Enumeration date
03/02/2011
Last updated
08/10/2016
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