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General NPI Number Information
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NPI Number | 1568425361
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Entity Type | Organization
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Legal Business Name | RANDOLPH EAR, NOSE & THROAT ASSOCIATES, P.A.
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Dates
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Enumeration Date | 04/11/2006
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Last Update Date | 09/08/2008
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Provider Practice Location Address
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Address Line | 124 N PARK ST
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City | ASHEBORO
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State | NC
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Zip | 27203-5440
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Country | US
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Telephone | 336-625-1007
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Fax | 336-625-0350
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Provider Business Mailing Address
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Address Line | 124 N PARK ST
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City | ASHEBORO
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State | NC
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Zip | 27203-5440
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Country | US
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Telephone | 336-625-1007
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Fax | 336-625-0350
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | MR. CHARLES BRANTLEY WEST
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Credential | M.D.
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Telephone | 336-625-1007
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207YX0007X
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Taxonomy Name | Plastic Surgery within the Head & Neck (Otolaryngology) Physician
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License Number |
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License Number State |
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