Provider Demographics
NPI:1104475219
Name:CAROLINA NEUROLOGICAL CONSULTING, PLLC
Entity type:Organization
Organization Name:CAROLINA NEUROLOGICAL CONSULTING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:DUBISKY
Authorized Official - Suffix:JR
Authorized Official - Credentials:DO
Authorized Official - Phone:704-671-4080
Mailing Address - Street 1:1061 X RAY DR
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-7489
Mailing Address - Country:US
Mailing Address - Phone:704-671-4080
Mailing Address - Fax:855-827-3282
Practice Address - Street 1:1061 X RAY DR
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-7489
Practice Address - Country:US
Practice Address - Phone:231-357-4220
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-11
Last Update Date:2019-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty