Provider Demographics
NPI:1346205556
Name:EAST CAROLINA ORTHOPAEDICS, PLLC
Entity Type:Organization
Organization Name:EAST CAROLINA ORTHOPAEDICS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:BRADFORD
Authorized Official - Last Name:WHEATLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:252-634-2676
Mailing Address - Street 1:PO BOX 1694
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28563-1694
Mailing Address - Country:US
Mailing Address - Phone:252-634-2676
Mailing Address - Fax:252-633-3502
Practice Address - Street 1:1413 TATUM DR
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28560-4549
Practice Address - Country:US
Practice Address - Phone:252-634-2676
Practice Address - Fax:252-633-3502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-19
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC01804OtherBCBS OF NC
NC8901804Medicaid
NC8901804Medicaid