PEACHTREE ENT & FACIAL PLASTICS PA NPI 1255504924

NPI Information

NPI: 1255504924
Provider Name: PEACHTREE ENT & FACIAL PLASTICS PA
Classification: Otolaryngology - 207YX0905X
Entity Type: Organization

Specialization: Otolaryngology/Facial Plastic Surgery

CLIA Number: 34D0248520

Address:
145 MEDICAL PARK LANE
SUITE J
MURPHY, NC
ZIP 28906
Phone: (828) 837-3223
Get Directions

PEACHTREE ENT & FACIAL PLASTICS PA is an otolaryngology/facial plastic surgery otolaryngology in Murphy, NC. The provider is an otolaryngologist who specializes in the diagnosis and surgical treatment of head and neck conditions. PEACHTREE ENT & FACIAL PLASTICS PA NPI is 1255504924. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

145 MEDICAL PARK LANE
SUITE J
MURPHY, NC
ZIP 28906-663
Phone: (828) 837-3223
Fax: (828) 837-7706

The provider's authorized official is Richard Todd Weisenburger .
The authorized official title is President/owner and has the following contact phone number (828) 837-3223.

The CLIA number assigned to this NPI record is 34D0248520 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/2/2008 and was last updated on 3/31/2014.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207Y00000X	Otolaryngology		2007-01919	NORTH CAROLINA	No
2	207YX0905X	Otolaryngology	Otolaryngology/Facial Plastic Surgery	2007-01919	NORTH CAROLINA	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	5908853	MEDICAID	NORTH CAROLINA
2	82972	MEDICARE PIN	FLORIDA

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: 5/5/2024

NPI Synchronization or Removal

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