Charlotte Eye Ear Nose & Throat Associates, PA

Organization Active NPI Ophthalmology Physician · Belmont, NC

NPI 1114112893 · NPPES record last updated Jan 23, 2024

Key facts

NPI
1114112893
Entity type
Organization (NPI type 2)
Primary specialty
Ophthalmology Physician 207W00000X
Legal business name
CHARLOTTE EYE EAR NOSE & THROAT ASSOCIATES, PA
Practice address
400 Park St
Belmont, NC 28012-3368
Phone
(704) 295-3000
Fax
(704) 838-8494
NPI assigned
Sep 6, 2007
Organization subpart
No

Authorized official

Name
Jag S Gill, SCD
Title
Ceo
Phone
(704) 295-3000

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D0941192Charlotte Eye Ear Nose & Throat Assocs PA
400 Park Street, Belmont, NC 28012
Certificate of waiverFeb 22, 2028

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207W00000X Yes
Otolaryngology Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207Y00000X

Addresses

Primary practice location

400 Park St
Belmont, NC 28012-3368

Mailing address

6035 Fairview Rd
Charlotte, NC 28210-3256
Phone (704) 295-3000

Other providers in Belmont, NC

All providers in Belmont, NC · Ophthalmology Physician in North Carolina

Sources for this page

Verify at the official NPI Registry.