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General NPI Number Information
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NPI Number | 1801956859
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Entity Type | Organization
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Legal Business Name | NORTHEAST SURGICAL SPECIALTIES, LLC
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 01/26/2016
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Provider Practice Location Address
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Address Line | 1090 NORTHEAST GATEWAY COURT NE SUITE 204
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City | CONCORD
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State | NC
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Zip | 28025-2440
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Country | US
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Telephone | 704-403-7020
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Fax | 704-403-7039
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Provider Business Mailing Address
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Address Line | 1090 NORTHEAST GATEWAY COURT NE SUITE 204
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City | CONCORD
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State | NC
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Zip | 28025-2440
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Country | US
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Telephone | 704-403-7020
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Fax | 704-403-7039
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Authorized Official
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Title or Position | SR VP
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Name | THOMAS F LAYMON
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Credential |
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Telephone | 704-403-2276
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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 |
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License Number State |
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