Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 2003-01479 | NC |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 2003-01479 | NC |
NPI | 1497734156 |
---|---|
Provider Name | Dr. Carroll Payne Jones III |
First Address | Charlotte, NC 28209-3239 |
Second Address | Charlotte, NC 28207-1219 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2006 |
Last Update Date | 15/06/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
89138TF | (05) | NC |
H87307 | (02) | NC |