| |
1991 Fordham Dr, Suite 301, Fayetteville, NC 28304-3773 | |
(910) 485-2020 | |
(910) 485-7571 |
Full Name | |
---|---|
Type | Facility |
Speciality | Ophthalmology |
Location | 1991 Fordham Dr, Fayetteville, North Carolina |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1265587828 | NPI | - | NPPES |
01199 | Other | NC | BCBS |
5950279 | Medicaid | NC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Secondary |
207W00000X | Ophthalmology | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
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2170 Midland Rd Ste 301, Southern Pines, NC 28387-2927 Ph: (910) 295-2100 | 1991 Fordham Dr, Suite 301, Fayetteville, NC 28304-3773 Ph: (910) 485-2020 |