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General NPI Number Information
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NPI Number | 1669441010
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Entity Type | Organization
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Legal Business Name | CAMPBELL EAR, NOSE & THROAT, PA
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Dates
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Enumeration Date | 03/17/2006
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Last Update Date | 10/04/2018
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Provider Practice Location Address
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Address Line | 4760 INDEPENDENCE DRIVE
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City | LUMBERTON
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State | NC
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Zip | 28358-2835
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Country | US
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Telephone | 910-738-1038
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Fax | 910-738-1472
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Provider Business Mailing Address
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Address Line | PO BOX 1246
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City | LUMBERTON
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State | NC
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Zip | 28359-1246
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Country | US
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Telephone | 910-738-1038
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Fax | 910-738-1472
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | CATHY POWERS
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Credential |
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Telephone | 910-738-1038
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State | NC
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