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General NPI Number Information
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NPI Number | 1124070115
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Entity Type | Organization
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Legal Business Name | ORTHOPAEDIC SPECIALISTS OF THE CAROLINAS, P.A.
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Dates
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Enumeration Date | 05/17/2006
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Last Update Date | 04/08/2011
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Provider Practice Location Address
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Address Line | 170 KIMEL PARK DR
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City | WINSTON SALEM
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State | NC
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Zip | 27103-6946
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Country | US
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Telephone | 336-768-1270
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Fax | 336-765-6375
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Provider Business Mailing Address
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Address Line | PO BOX 25626
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City | WINSTON SALEM
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State | NC
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Zip | 27114-5626
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Country | US
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Telephone | 336-768-1270
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Fax | 336-765-6375
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Authorized Official
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Title or Position | BUSINESS OFFICE MANAGER
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Name | MRS. REGINA A HAYES
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Credential |
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Telephone | 336-659-4111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number |
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License Number State |
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