Provider Demographics
NPI:1003174483
Name:COASTAL ORTHOPAEDICS AND SPINAL SURGERY, PA
Entity Type:Organization
Organization Name:COASTAL ORTHOPAEDICS AND SPINAL SURGERY, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:BATTERSBY
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:252-635-1788
Mailing Address - Street 1:612B MCCARTHY BLVD
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28562-5231
Mailing Address - Country:US
Mailing Address - Phone:252-635-1788
Mailing Address - Fax:252-635-3053
Practice Address - Street 1:3310 TRENT RD
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28562-5705
Practice Address - Country:US
Practice Address - Phone:252-636-0035
Practice Address - Fax:252-636-0036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-24
Last Update Date:2012-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC020HMOtherBCBS
NC2327361Medicare PIN