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General NPI Number Information
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NPI Number | 1831639509
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Entity Type | Organization
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Legal Business Name | CAROLINAS PHYSICIANS NETWORK INC
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Dates
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Enumeration Date | 03/01/2017
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Last Update Date | 12/06/2019
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Provider Practice Location Address
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Address Line | 8840 BLAKENEY PROFESSIONAL DR STE 100
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City | CHARLOTTE
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State | NC
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Zip | 28277-6718
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Country | US
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Telephone | 704-667-2340
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 19305
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City | CHARLOTTE
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State | NC
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Zip | 28219-9305
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Country | US
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Telephone | 704-631-0002
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Fax |
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Authorized Official
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Title or Position | SENIOR VICE PRESIDENT
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Name | THOMAS LAYMON
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Credential |
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Telephone | 704-446-8250
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RS0010X
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Taxonomy Name | Sports Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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