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General NPI Number Information
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NPI Number | 1215931910
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Entity Type | Organization
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Legal Business Name | CAROLINA SPINE & NEUROSURGERY CENTER PA
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Dates
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Enumeration Date | 06/09/2005
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Last Update Date | 11/30/2010
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Provider Practice Location Address
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Address Line | 7 VANDERBILT PARK DR
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City | ASHEVILLE
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State | NC
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Zip | 28803-1700
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Country | US
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Telephone | 828-255-7776
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Fax | 828-274-7855
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Provider Business Mailing Address
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Address Line | PO BOX 25370
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City | ASHEVILLE
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State | NC
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Zip | 28813-1370
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Country | US
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Telephone | 828-255-7776
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Fax | 828-255-8794
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RALPH C LOOMIS
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Credential | MD
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Telephone | 828-255-7776
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 39607
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | 39607
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License Number State | NC
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