Provider Demographics
NPI:1629487814
Name:OCULOPLASTIC CONSULTANTS OF THE CAROLINAS, PLLC
Entity Type:Organization
Organization Name:OCULOPLASTIC CONSULTANTS OF THE CAROLINAS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:K
Authorized Official - Last Name:ESCARAVAGE
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:910-444-0707
Mailing Address - Street 1:1025 MEDICAL CENTER DR STE 201
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-7355
Mailing Address - Country:US
Mailing Address - Phone:910-444-0707
Mailing Address - Fax:910-444-0708
Practice Address - Street 1:1025 MEDICAL CENTER DR STE 201
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401
Practice Address - Country:US
Practice Address - Phone:910-444-0707
Practice Address - Fax:910-444-0708
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-13
Last Update Date:2018-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200600645207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty