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EAR NOSE & THROAT ASSC OF CHARL INC NPI 1295735850


NPI Information

NPI: 1295735850
Provider Name: EAR NOSE & THROAT ASSC OF CHARL INC
Classification: Otolaryngology - 207Y00000X
Entity Type: Organization
Address:
500 DONNALLY ST
SUITE 200
CHARLESTON, WV
ZIP 25301
Phone: (304) 342-0124
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EAR NOSE & THROAT ASSC OF CHARL INC is an otolaryngology in Charleston, WV. 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. EAR NOSE & THROAT ASSC OF CHARL INC NPI is 1295735850. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

500 DONNALLY ST
SUITE 200
CHARLESTON, WV
ZIP 25301-648
Phone: (304) 342-0124
Fax: (304) 340-2204

The provider's authorized official is Frederick Thomas Sporck .
The authorized official title is Physician Director and has the following contact phone number (304) 340-2225.

The enumeration date for this NPI number is 7/26/2005 and was last updated on 10/12/2012.


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
1207Y00000XOtolaryngology=========WEST VIRGINIAYes

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
10008888000MEDICAIDWEST VIRGINIA
20778148001OTHERWEST VIRGINIACIGNA
39149651MEDICARE ID-TYPE UNSPECIFIEDWEST VIRGINIA
4CA7089OTHERWEST VIRGINIARR MEDICARE

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: 11/14/2023

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