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Charlotte Eye Ear Nose & Throat Associates, PA

Organization Active NPI Otolaryngology Physician · Charlotte, NC

NPI 1710271507 · NPPES record last updated Apr 30, 2013

Key facts

NPI
1710271507
Entity type
Organization (NPI type 2)
Primary specialty
Otolaryngology Physician 207Y00000X
Legal business name
CHARLOTTE EYE EAR NOSE & THROAT ASSOCIATES, PA
Practice address
2614 E 7TH St
Charlotte, NC 28204-4375
Phone
(704) 376-1220
Fax
(704) 376-1229
NPI assigned
Jun 9, 2011
Organization subpart
No

Authorized official

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

Corporate family (same tax ID) 18

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Charlotte Eenthroat Asoc (19 organizations share this tax ID)

Specialties & licenses

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

Addresses

Primary practice location

2614 E 7TH St
Charlotte, NC 28204-4375

Mailing address

2614 E 7TH St
Charlotte, NC 28204-4375
Phone (704) 376-1220

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 30, 2013.

{
    "created_epoch": "1307577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367280000000",
    "number": "1710271507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2614 E 7TH ST",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282044375",
            "telephone_number": "704-376-1220",
            "fax_number": "704-376-1229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2614 E 7TH ST",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282044375",
            "telephone_number": "704-376-1220",
            "fax_number": "704-376-1229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLOTTE EYE EAR NOSE & THROAT ASSOCIATES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-09",
        "last_updated": "2013-04-30",
        "status": "A",
        "authorized_official_last_name": "GILL",
        "authorized_official_first_name": "JAG",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "704-295-3000",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "SCD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

All providers in Charlotte, NC · Otolaryngology Physician in North Carolina

Sources for this page

Verify at the official NPI Registry.