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General NPI Number Information
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NPI Number | 1962535252
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Entity Type | Organization
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Legal Business Name | CABARRUS EAR NOSE THROAT & FACIAL SURGERY CENTER PA
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Dates
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Enumeration Date | 03/14/2007
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Last Update Date | 03/11/2015
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Provider Practice Location Address
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Address Line | 1018 LEE ANN DR NE
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City | CONCORD
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State | NC
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Zip | 28025-2911
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Country | US
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Telephone | 704-782-7111
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Fax |
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Provider Business Mailing Address
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Address Line | 1018 LEE ANN DR NE
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City | CONCORD
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State | NC
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Zip | 28025-2911
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Country | US
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Telephone | 704-782-7111
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Fax |
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Authorized Official
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Title or Position | MEDICAL DOCTOR
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Name | MR. ROBERT CLAYTON JARCHOW
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Credential | M.D.
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Telephone | 704-782-7111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207YS0123X
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Taxonomy Name | Facial Plastic Surgery Physician
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License Number | 39284
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License Number State | NC
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