Provider Demographics
NPI:1275554263
Name:WESTERN CAROLINA ORTHOPAEDIC SPECIALISTS, PA
Entity Type:Organization
Organization Name:WESTERN CAROLINA ORTHOPAEDIC SPECIALISTS, PA
Other - Org Name:PRECISION ORTHOPAEDIC SURGERY
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOFER
Authorized Official - Middle Name:C
Authorized Official - Last Name:CATTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:828-452-4131
Mailing Address - Street 1:581 LEROY GEORGE DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CLYDE
Mailing Address - State:NC
Mailing Address - Zip Code:28721-8085
Mailing Address - Country:US
Mailing Address - Phone:828-452-4131
Mailing Address - Fax:828-452-4095
Practice Address - Street 1:581 LEROY GEORGE DR
Practice Address - Street 2:SUITE 300
Practice Address - City:CLYDE
Practice Address - State:NC
Practice Address - Zip Code:28721-8085
Practice Address - Country:US
Practice Address - Phone:828-452-4131
Practice Address - Fax:828-452-4095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200500835207X00000X
NC200701605207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCDC6475OtherRAILROAD MEDICARE
NC019AROtherBCBSNC
NC5906568Medicaid
NC5906568Medicaid
NC2340195Medicare ID - Type UnspecifiedMCR GROUP NUMBER