Healthcare Provider Details

I. General information

NPI: 1831413475
Provider Name (Legal Business Name): CAROLINAS PHYSICIANS NETWORK INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2010
Last Update Date: 10/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

579 GREENWAY RD SUITE 200
BOONE NC
28607-4974
US

IV. Provider business mailing address

PO BOX 601067
CHARLOTTE NC
28260-1067
US

V. Phone/Fax

Practice location:
  • Phone: 704-381-3970
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License Number
License Number State

VIII. Authorized Official

Name: THOMAS LAYMON
Title or Position: SENIOR VICE PRESIDENT
Credential:
Phone: 704-446-8250