| |
795 Us Highway 64 E, Plymouth, NC 27962-9314 | |
(252) 793-2103 | |
(252) 793-5154 |
Full Name | |
---|---|
Type | Facility |
Speciality | Optometrist |
Location | 795 Us Highway 64 E, Plymouth, North Carolina |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1700833175 | NPI | - | NPPES |
890172V | Medicaid | NC | |
0172V | Other | NC | BCBSNC GROUP NUMBER |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
---|---|
795 Us Highway 64 E, Plymouth, NC 27962-9314 Ph: (252) 793-2103 | 795 Us Highway 64 E, Plymouth, NC 27962-9314 Ph: (252) 793-2103 |