Healthcare Provider Details

I. General information

NPI: 1679895759
Provider Name (Legal Business Name): CAROLINA SPINE & NEUROSURGERY CENTER PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2010
Last Update Date: 11/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

129 HOSPITAL DRIVE
SPRUCE PINE NC
28777-3035
US

IV. Provider business mailing address

PO BOX 25370
ASHEVILLE NC
28813-1370
US

V. Phone/Fax

Practice location:
  • Phone: 828-255-7776
  • Fax: 828-274-5134
Mailing address:
  • Phone: 828-255-7776
  • Fax: 828-274-5134

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: KEVIN FLEMING
Title or Position: CEO
Credential:
Phone: 828-255-7776