Healthcare Provider Details
I. General information
NPI: 1043287469
Provider Name (Legal Business Name): CHARLOTTE EYE EAR NOSE & THROAT ASSOCIATES, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/03/2006
Last Update Date: 02/12/2025
Certification Date: 02/12/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6035 FAIRVIEW RD
CHARLOTTE NC
28210-3256
US
IV. Provider business mailing address
6035 FAIRVIEW RD
CHARLOTTE NC
28210-3256
US
V. Phone/Fax
- Phone: 704-295-3000
- Fax: 704-838-8494
- Phone: 704-295-3000
- Fax: 704-838-8494
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Y00000X |
| Taxonomy | Otolaryngology Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207W00000X |
| Taxonomy | Ophthalmology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
GREGORY
S
PARSONS
Title or Position: PRESIDENT
Credential: MD
Phone: 803-327-4000