Provider Type Icon

RALEIGH CAPITOL EAR NOSE AND THROAT NPI 1902170442


NPI Information

NPI: 1902170442
Provider Name: RALEIGH CAPITOL EAR, NOSE, AND THROAT
Classification: Otolaryngology - 207Y00000X
Entity Type: Organization

CLIA Number: 34D2045672

Address:
4600 LAKE BOONE TRL
RALEIGH, NC
ZIP 27607
Phone: (919) 787-1374
Get Directions

RALEIGH CAPITOL EAR, NOSE, AND THROAT is an otolaryngology in Raleigh, NC. The provider is an otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. RALEIGH CAPITOL EAR, NOSE, AND THROAT NPI is 1902170442. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4600 LAKE BOONE TRL
RALEIGH, NC
ZIP 27607-528
Phone: (919) 787-1374
Fax: (919) 420-2028

The provider's authorized official is Mark W Clarkson .
The authorized official title is President and has the following contact phone number (919) 787-7171.

The CLIA number assigned to this NPI record is 34D2045672 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/1/2012 and was last updated on 10/6/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Y00000XOtolaryngologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1PE-YPU8T38FAMEDICAIDNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.