Healthcare Provider Details

I. General information

NPI: 1417909409
Provider Name (Legal Business Name): ALAMANCE EAR NOSE AND THROAT, LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 06/17/2022
Certification Date: 06/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4030 OAKS PROFESSIONAL PKWY STE 201
BURLINGTON NC
27215-8491
US

IV. Provider business mailing address

PO BOX 2
BURLINGTON NC
27216-0002
US

V. Phone/Fax

Practice location:
  • Phone: 336-226-0660
  • Fax: 336-227-6327
Mailing address:
  • Phone: 336-226-0660
  • Fax: 336-227-6327

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State

VIII. Authorized Official

Name: CHAPMAN TEAGUE MCQUEEN
Title or Position: MD
Credential:
Phone: 336-226-0660