Provider Demographics
NPI:1508828286
Name:CAROLINA ONCOLOGY ASSOC PA
Entity Type:Organization
Organization Name:CAROLINA ONCOLOGY ASSOC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:MCCALL
Authorized Official - Last Name:BRINKLEY
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:704-636-5542
Mailing Address - Street 1:825 W HENDERSON ST
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28144-2725
Mailing Address - Country:US
Mailing Address - Phone:704-636-5542
Mailing Address - Fax:855-662-2141
Practice Address - Street 1:825 W HENDERSON ST
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144-2725
Practice Address - Country:US
Practice Address - Phone:704-636-5542
Practice Address - Fax:855-662-2141
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0000S174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890298PMedicaid
NCCI5592OtherRRMEDICARE
NC2325189Medicare PIN