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General NPI Number Information
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NPI Number | 1306644521
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Entity Type | Organization
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Legal Business Name | CAROLINA ORTHOPAEDIC & SPORTS MEDICINE CENTER PA
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Dates
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Enumeration Date | 03/04/2025
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Last Update Date | 06/17/2025
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Provider Practice Location Address
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Address Line | 210 BEATTY DR STE 100
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City | BELMONT
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State | NC
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Zip | 28012-2716
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Country | US
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Telephone | 704-266-3100
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Fax | 704-867-6401
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Provider Business Mailing Address
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Address Line | 2345 COURT DR
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City | GASTONIA
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State | NC
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Zip | 28054-2151
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Country | US
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Telephone | 704-865-0077
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Fax | 704-867-6401
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Authorized Official
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Title or Position | PRESIDENT
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Name | HENRY CLAYTON THOMASON
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Credential | MD
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Telephone | 704-865-0077
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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