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General NPI Number Information
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NPI Number | 1235247933
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Entity Type | Organization
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Legal Business Name | CAROLINA EAR, NOSE & THROAT HEAD AND NECK SURGERY CENTER
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Dates
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Enumeration Date | 08/25/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 401 MULBERRY ST SW SUITE 105
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City | LENOIR
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State | NC
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Zip | 28645-5463
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Country | US
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Telephone | 828-754-2464
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Fax | 828-759-0894
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Provider Business Mailing Address
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Address Line | 256C 10TH AVE NE
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City | HICKORY
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State | NC
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Zip | 28601-3832
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Country | US
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Telephone | 828-322-2183
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Fax | 828-328-4526
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. WILLARD CARDWELL HARRILL
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Credential | M.D.
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Telephone | 828-322-2183
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number |
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License Number State |
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