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General NPI Number Information
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NPI Number | 1881049104
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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 | 04/25/2016
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Last Update Date | 04/25/2016
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Provider Practice Location Address
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Address Line | 1690 HIGHWAY 160 W
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City | FORT MILL
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State | SC
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Zip | 29708-8024
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Country | US
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Telephone | 803-548-2424
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 602148
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City | CHARLOTTE
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State | NC
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Zip | 28260-2148
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Country | US
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Telephone | 803-548-2424
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | THOMAS FORD 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 | 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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