Provider Demographics
NPI:1053364083
Name:GOLDSBORO NEUROLOGICAL SURGERY, PA
Entity type:Organization
Organization Name:GOLDSBORO NEUROLOGICAL SURGERY, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:IRVING
Authorized Official - Last Name:KATZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-731-4048
Mailing Address - Street 1:625 COUNTRY DAY RD
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27530-8888
Mailing Address - Country:US
Mailing Address - Phone:919-731-4048
Mailing Address - Fax:919-731-2402
Practice Address - Street 1:625 COUNTRY DAY RD
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27530-8888
Practice Address - Country:US
Practice Address - Phone:919-731-4048
Practice Address - Fax:919-731-2402
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC65701207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0293XOtherBLUE CROSS BLUE SHIELD
NC790293XMedicaid
NCDD2259OtherMEDICARE RR
NC0293XOtherBLUE CROSS BLUE SHIELD
NC2344072Medicare ID - Type Unspecified