1. Home
  2. Directory
  3. Georgia
  4. Carrollton
  5. Otolaryngology
  6. NPI Profile

CARROLLTON EAR, NOSE AND THROAT
NPI 1760410401
Otolaryngology in Carrollton, GA

Active since June 29, 2006CLIA Certified · 2 labs
150 CLINIC AVE, SUITE 201, CARROLLTON, GA 30117(770) 832-1488 Get Directions Write a Review

NPPES record last updated: July 18, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Carrollton Ear, Nose And Throat NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CARROLLTON EAR, NOSE AND THROAT (NPI 1760410401) is a healthcare organization registered as an otolaryngology in Carrollton, Georgia and active in the NPI registry since June 2006. The organization holds 2 active CLIA laboratory certificates and lists Vicki Williamson, Administrator, as its authorized official.

NPPES Registry Identity

NPI1760410401
Entity TypeOrganization
Primary Taxonomy207Y00000X
Legal Business NameCARROLLTON EAR, NOSE AND THROAT, P.C.
Location Address150 CLINIC AVE, SUITE 201Carrollton, GA 30117-4401
Mailing Address150 Clinic Ave, Suite 201Carrollton, GA 30117-4401 · (770) 832-1488
Phone(770) 832-1488
Organization SubpartNo
Authorized OfficialVicki WilliamsonAdministrator · (770) 832-1488
Enumeration DateJune 29, 2006
Last NPPES UpdateJuly 18, 2022
NPPES CertifiedJuly 18, 2022
✔ NPI 1760410401 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians
Taxonomy Code207Y00000X
Definition
An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.
150 CLINIC AVE, Carrollton, GA 30117
Open in Google Maps ↗

Other Names 1

Other NameCarrollton Ear, Nose And Throat

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 11D0256208

Carrollton Ear Nose & Throat · Carrollton, GA
Active · expires May 2, 2028
CLIA Number11D0256208
Laboratory TypePhysician Office
Certificate Effective DateMay 3, 2026
Certificate Expiration DateMay 2, 2028
Laboratory DirectorJohn C. Pezold
Laboratory Phone(770) 832-1488
Laboratory LocationCarrollton Ear Nose & Throat150 Clinic Avenue Suite 201, Carrollton, GA 30117
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 11D1086146

Carrollton Ear Nose And Throat · Bremen, GA
Active · expires Jul 6, 2028
CLIA Number11D1086146
Laboratory TypePhysician Office
Certificate Effective DateJuly 7, 2026
Certificate Expiration DateJuly 6, 2028
Laboratory DirectorL Mark Gustafson
Laboratory Phone(770) 832-1488
Laboratory LocationCarrollton Ear Nose And Throat204 Allen Memorial Drive Suite 103, Bremen, GA 30110
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. WILLIAM BRADLEY GAMBRELL M.D.
Otolaryngology
150 CLINIC AVE, SUITE 201
CARROLLTON, GA 30117
Carroll County (770) 832-1488
DR. JUBAL R WATTS M.D.
Orthopaedic Surgery
150 CLINIC AVE, STE 101
CARROLLTON, GA 30117
Carroll County (770) 834-0873
MRS. PAIGE DIANE LAMBERT M.A., CCC-A
Audiologist
150 CLINIC AVE, SUITE 201
CARROLLTON, GA 30117
Carroll County (770) 832-1488
L MARK GUSTAFSON M.D.
Otolaryngology
150 CLINIC AVE, SUITE 201
CARROLLTON, GA 30117
Carroll County (770) 832-1488
MELANIE JORDAN
Orthopaedic Surgery
150 CLINIC AVE, SUITE 101
CARROLLTON, GA 30117
Carroll County (678) 601-5220
SHOMARI ANDRE RUFFIN M.D.
Orthopaedic Surgery (Sports Medicine)
150 CLINIC AVE, SUITE 101
CARROLLTON, GA 30117
Carroll County (770) 834-0873
DR. GREGORY S SLAPPEY MD
Orthopaedic Surgery
150 CLINIC AVE, SUITE 101
CARROLLTON, GA 30117
Carroll County (770) 834-0873
JAMES WESLEY CULLISON MD
Urology
150 CLINIC AVE, SUITE 202
CARROLLTON, GA 30117
Carroll County (770) 834-6988

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Carrollton Ear, Nose And Throat, P.C.'s NPI number?

The NPI number for Carrollton Ear, Nose And Throat, P.C. is 1760410401. It was assigned to this organization in the NPPES registry on June 29, 2006. The provider is also known as Carrollton Ear, Nose And Throat.

Where is Carrollton Ear, Nose And Throat, P.C. located?

Carrollton Ear, Nose And Throat, P.C. is located at 150 Clinic Ave Suite 201, Carrollton, GA 30117. The listed phone number is (770) 832-1488.

What is Carrollton Ear, Nose And Throat, P.C.'s specialty?

The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.

Does Carrollton Ear, Nose And Throat, P.C. hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Carrollton Ear, Nose And Throat, P.C. was last updated on July 18, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.