Healthcare Provider Details

I. General information

NPI: 1932036712
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: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 JOHNSON RIDGE MEDICAL PARK
ELKIN NC
28621-2443
US

IV. Provider business mailing address

6035 FAIRVIEW RD
CHARLOTTE NC
28210-3256
US

V. Phone/Fax

Practice location:
  • Phone: 336-526-1977
  • Fax: 336-526-0061
Mailing address:
  • Phone: 704-295-3000
  • Fax: 704-838-8494

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State

VIII. Authorized Official

Name: GREGORY STOKES PARSONS
Title or Position: CREDENTIALING MANAGER
Credential: MD
Phone: 704-295-3000