Provider Demographics
NPI:1023256518
Name:CAROLINA HEADACHE INSTITUTE, PA
Entity type:Organization
Organization Name:CAROLINA HEADACHE INSTITUTE, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:G
Authorized Official - Last Name:FISHER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:919-942-4424
Mailing Address - Street 1:6114 FAYETTEVILLE RD STE 109
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-6284
Mailing Address - Country:US
Mailing Address - Phone:919-942-4424
Mailing Address - Fax:919-942-4440
Practice Address - Street 1:6114 FAYETTEVILLE RD STE 109
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-6284
Practice Address - Country:US
Practice Address - Phone:919-942-4424
Practice Address - Fax:919-942-4440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty