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General NPI Number Information
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NPI Number | 1396730883
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Entity Type | Organization
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Legal Business Name | KASSELT BONE AND JOINT CENTER, P.A.
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Dates
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Enumeration Date | 09/12/2005
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Last Update Date | 12/15/2009
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Provider Practice Location Address
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Address Line | 2104 N HERRITAGE ST
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City | KINSTON
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State | NC
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Zip | 28501-2222
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Country | US
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Telephone | 252-523-6506
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Fax | 252-523-6969
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Provider Business Mailing Address
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Address Line | 2104 N HERRITAGE ST
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City | KINSTON
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State | NC
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Zip | 28501-2222
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Country | US
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Telephone | 252-523-6506
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Fax | 252-523-6969
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. MAX R KASSELT
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Credential | M.D.
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Telephone | 252-523-6506
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 35389
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License Number State | NC
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