Provider Demographics
NPI:1164696316
Name:PIEDMONT VISTA EAR NOSE THROAT ALLERGY AND SLEEP ASSOCIATES, PLLC
Entity Type:Organization
Organization Name:PIEDMONT VISTA EAR NOSE THROAT ALLERGY AND SLEEP ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:OAKES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-728-2003
Mailing Address - Street 1:1733 CONNELLY SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:LENOIR
Mailing Address - State:NC
Mailing Address - Zip Code:28645-7827
Mailing Address - Country:US
Mailing Address - Phone:828-728-2003
Mailing Address - Fax:
Practice Address - Street 1:1733 CONNELLY SPRINGS RD
Practice Address - Street 2:
Practice Address - City:LENOIR
Practice Address - State:NC
Practice Address - Zip Code:28645-7827
Practice Address - Country:US
Practice Address - Phone:828-728-2003
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-18
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2007-01984174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty