Provider Demographics
NPI:1083695514
Name:CARTERET SURGERY CENTER PLLC
Entity Type:Organization
Organization Name:CARTERET SURGERY CENTER PLLC
Other - Org Name:CARTERET SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:K
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:252-247-0314
Mailing Address - Street 1:3714 GUARDIAN AVE
Mailing Address - Street 2:STE W
Mailing Address - City:MOREHEAD CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28557-4322
Mailing Address - Country:US
Mailing Address - Phone:252-247-0314
Mailing Address - Fax:252-247-2031
Practice Address - Street 1:3714 GUARDIAN AVE
Practice Address - Street 2:STE W
Practice Address - City:MOREHEAD CITY
Practice Address - State:NC
Practice Address - Zip Code:28557-4322
Practice Address - Country:US
Practice Address - Phone:252-247-0314
Practice Address - Fax:252-247-2031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCAS0061261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical