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503 Island Ford Rd, Maiden, NC 28650-8741 | |
(828) 428-9175 | |
(828) 428-9490 |
Full Name | |
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Type | Facility |
Speciality | Optometrist |
Location | 503 Island Ford Rd, Maiden, North Carolina |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1578565305 | NPI | - | NPPES |
89013R0 | Medicaid | NC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (North Carolina) | Primary |
Provider Name | David J Kulesia |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1437151321 PECOS PAC ID: 5597678904 Enrollment ID: I20031111000702 |
Provider Name | Donald R Macqueen |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1740330539 PECOS PAC ID: 5395737928 Enrollment ID: I20040401001403 |
Provider Name | Matthew James Davis |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1659707230 PECOS PAC ID: 5193950905 Enrollment ID: I20131104000827 |
Provider Name | Hannah Glenn |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1033889787 PECOS PAC ID: 7012315278 Enrollment ID: I20211001003023 |
Mailing Address | Practice Location Address |
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Po Box 276, Maiden, NC 28650-0276 Ph: (828) 428-9175 | 503 Island Ford Rd, Maiden, NC 28650-8741 Ph: (828) 428-9175 |