Provider Demographics
NPI:1477898922
Name:CAROLINA AUDIOLOGY ASSOCIATES
Entity Type:Organization
Organization Name:CAROLINA AUDIOLOGY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:L
Authorized Official - Last Name:MIZE
Authorized Official - Suffix:SR
Authorized Official - Credentials:AUD
Authorized Official - Phone:252-977-4327
Mailing Address - Street 1:4065 CAPITAL DR
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27804-3123
Mailing Address - Country:US
Mailing Address - Phone:252-977-4327
Mailing Address - Fax:252-977-4329
Practice Address - Street 1:4065 CAPITAL DR
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804-3123
Practice Address - Country:US
Practice Address - Phone:252-977-4327
Practice Address - Fax:252-977-4329
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-10
Last Update Date:2012-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1021231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty