Provider Demographics
NPI:1053905158
Name:CAROLINA JOINT AND ARTHRITIS CLINIC
Entity type:Organization
Organization Name:CAROLINA JOINT AND ARTHRITIS CLINIC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER / OPERATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SHERMAN
Authorized Official - Middle Name:AUSTIN
Authorized Official - Last Name:YEARGAN
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:910-398-7000
Mailing Address - Street 1:5725 OLEANDER DR STE E4
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-4746
Mailing Address - Country:US
Mailing Address - Phone:910-769-7878
Mailing Address - Fax:910-769-8967
Practice Address - Street 1:5725 OLEANDER DR STE E4
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-4746
Practice Address - Country:US
Practice Address - Phone:910-769-7878
Practice Address - Fax:910-769-8967
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-01
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty