Healthcare Provider Details

I. General information

NPI: 1053905158
Provider Name (Legal Business Name): CAROLINA JOINT AND ARTHRITIS CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2021
Last Update Date: 09/26/2024
Certification Date: 09/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5725 OLEANDER DR STE E4
WILMINGTON NC
28403-4746
US

IV. Provider business mailing address

5725 OLEANDER DR STE E4
WILMINGTON NC
28403-4746
US

V. Phone/Fax

Practice location:
  • Phone: 910-769-7878
  • Fax: 910-769-8967
Mailing address:
  • Phone: 910-769-7878
  • Fax: 910-769-8967

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: DR. SHERMAN AUSTIN YEARGAN III
Title or Position: OWNER / OPERATOR
Credential: MD
Phone: 910-398-7000