Provider Demographics
NPI:1821503947
Name:CARTERET SURGICAL ASSOCIATES P.A.
Entity Type:Organization
Organization Name:CARTERET SURGICAL ASSOCIATES P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALIST
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:JACOB
Authorized Official - Last Name:WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-222-5862
Mailing Address - Street 1:3714 GUARDIAN AVE STE E
Mailing Address - Street 2:
Mailing Address - City:MOREHEAD CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28557-2975
Mailing Address - Country:US
Mailing Address - Phone:252-222-5862
Mailing Address - Fax:252-247-9469
Practice Address - Street 1:3700 SYMI CIR
Practice Address - Street 2:
Practice Address - City:MOREHEAD CITY
Practice Address - State:NC
Practice Address - Zip Code:28557-4309
Practice Address - Country:US
Practice Address - Phone:252-222-5888
Practice Address - Fax:252-773-0506
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CARTERET SURGICAL ASSOCIATES P.A.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-12-12
Last Update Date:2017-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty