Provider Demographics
NPI:1033243563
Name:CAROLINA ONCOLOGY ASSOCIATES
Entity Type:Organization
Organization Name:CAROLINA ONCOLOGY ASSOCIATES
Other - Org Name:WILLIAM M BRINKLEY MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:BRINKLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:704-636-5542
Mailing Address - Street 1:825 W HENDERSON ST
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28144-2725
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:825 W HENDERSON ST
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144-2725
Practice Address - Country:US
Practice Address - Phone:704-636-5542
Practice Address - Fax:704-636-5142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC19313332900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site
Provider Identifiers
StateIdentifier IDID TypeIssuer
3407423OtherOTHER ID NUMBER-COMMERCIAL NUMBER
NC890298PMedicaid
3407423OtherOTHER ID NUMBER