Provider Demographics
NPI:1649322199
Name:EAST CAROLINA ORTHOPAEDICS, PLLC
Entity type:Organization
Organization Name:EAST CAROLINA ORTHOPAEDICS, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
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:252-633-0361
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:252-633-0361
Mailing Address - Fax:252-633-2577
Practice Address - Street 1:2007 NEUSE BLVD
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28560-3454
Practice Address - Country:US
Practice Address - Phone:252-633-0361
Practice Address - Fax:252-633-2577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC01804OtherBCBSNC
NC8901804Medicaid
NC0943Medicare ID - Type Unspecified