Provider Demographics
NPI:1649376898
Name:CAROLINA NEUROSURGICAL SERVICES, P.A.
Entity type:Organization
Organization Name:CAROLINA NEUROSURGICAL SERVICES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:
Authorized Official - Last Name:JAUFMANN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:910-484-9802
Mailing Address - Street 1:3650 CAPE CENTER DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-4406
Mailing Address - Country:US
Mailing Address - Phone:910-484-9802
Mailing Address - Fax:910-484-2342
Practice Address - Street 1:3650 CAPE CENTER DR
Practice Address - Street 2:SUITE 100
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-4406
Practice Address - Country:US
Practice Address - Phone:910-484-9802
Practice Address - Fax:910-484-2342
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890229HMedicaid
NC0229HOtherBLUE CROSS BLUE SHIELD
NC890229HMedicaid